Blue Cross Blue Shield CEO Tresnowski calls for insurance reform. Interview by Richard L. Clarke.

The Blue Cross Blue Shield Association is the coordinating organization for the 70 independent Blue Cross Blue Shield plans across the United States. In an interview with Richard L. Clarke, FHFMA, president, Healthcare Financial Management Association, Bernard R. Tresnowski, Blue Cross Blue Shield's president and chief executive officer, addresses the issue of healthcare reform, some of which he believes may be implemented as early as next summer. In addition, Tresnowski discusses the need for insurance reform, offers reasons why some Blue Cross plans have failed, reinforces his belief in the benefits of administrative simplification, and emphasizes the strengths of linking financing and delivery.

Building a foundation for universal access.

Specific strategies outlined by the Blue Cross and Blue Shield Association call for a restructuring of health care financing that builds on a competitive, employer-based health insurance system. Universal access can be achieved through better management of the cost of care and more affordable health care premiums. Restructuring of the financing system must restore its capacity to manage risk and establish accountability for managing cost. Business practices and public policies that have encouraged market fragmentation should be reformed and incentives to create affordable insurance options for all buyers be established.