AMA bluntly criticized voluntary and private insurance plans due to inconclusive cases of profiteering and welfare by various organizations. In 1937, AMA advocated only county medical societies to play a role in the care of poor patients. Many labor unions and social organizations on their own part continued with their plans striving for better healthcare environment and improving patient-physician level of understanding. Basic insurance plans were modulated by the commercial insurers to include healthy section of the society on upgraded level. They charged them high because of specific set of medical services catered to them. This level of health care or premium care was new strategy by which the commercial insurers gained over the Blues by selling their insurance policies to young and healthy group, predominantly urban employees. Experience rating as the commercial insurers put it forward was based on health situation rather than monetary infrastructure.
With lack of survey data and medical research, these profitable health policies continued for many decades in the United States by commercial insurers which were somewhat lackadaisical but made no adverse fallout. These policies showed no real improvement in further direction other than garnering huge profits for the commercial insurers. These policies targeted young and old on different level and in contrast price range. Among older generation, it was popular because little fees were charged for the medical services while the young were charged more. Eventually, the people enrolled with commercial insurers in large numbers and the ratio to the Blues increased in the 1950s. The idea of experience rating was closely connected to health insurance and employment. Group insurance plans were more effective due to reduced administrative efforts and cohesive medical services. The primary notion that only sick people will require an insurance policy became obsolete. The Blues suffered because of lack of proper agenda at the right time to increase sale of their insurance policies.
The companies benefited with regulated financial infrastructure. A renowned medical historian Jan Gregoire Combs in The Rise and Fall of HMOs wrote, “Marshfield and other nonprofits need government funding far in excess of the benefits from tax exemption to provide effective community service.” However, this period between late 1950s and 1960s was started known as Golden age of American medicine.