Blue Cross and Blue Shield were originally two separate organizations. Blue Cross offered hospitalization plans, while Blue Shield offered coverage for physicians' services. Both now offer the full gamut of health insurance. At the national level and in most states, the organizations have joined together.
Until the 1990's, all organizations had a non-commercial structure. Some plans have become for-profit organizations.
All member plans are run by not-for-profit organizations. Since Canada has national health insurance, the primary Blue Cross product is supplemental health benefits.