ABSTRACT
In recent years, there have been a large number of mergers and acquisitions of firms in the U.S. economy. In fact, between 1998 and including 2000, nearly $4 trillion in mergers were accomplished, more than in the preceding thirty years (Henry 2002). Presumably, in a forprofit economy, these buy-ins and buy-outs of firms between one and another can be interpreted as an effort by those firms that are bought and those that are sold to increase their combined profitability. However, these same trends can be observed in the nonprofit sector in the health care economy, where, in 1960s and 1970s, Blue Cross and Blue Shield were separate economic entities and were nonprofit organizations. Today, Blue Cross and Blue Shield entities in each state are largely merged, and operate as for-profit organizations (Feldstein 2005). What has happened?
