THE issue of health care costs usually comes up for discussion right after the economy as costs for businesses and consumers continue to climb. The Blue Cross Blue Shield Association insures 102 million Americans  one in three people  and has networks that include 90 percent of the nation’s providers and 80 percent of its hospitals.

The association’s board just adopted a four-point initiative aimed at containing health care costs and improving care. The goals range from eradicating hospital infections to pushing for health care coverage for everyone. From Chicago, Scott Serota, the association’s president and chief executive, recently discussed the new goals:

Q. What was the impetus for adopting a new plan of action, and why now?

A. Much of what is discussed in virtually all forums as health care reform is really health care financing reform. We really have not gotten sufficient national attention on the real underlying issue, which is that the entire health care delivery system needs to be modified. We, the Blues, feel we should try to drive toward a vision for the health care delivery system which we can move collectively forward with our partners.

Q. One of your goals is to cut the prevalence of diabetes in half. Why did you select that?

A. There are 57 million Americans today who are prediabetic. The cost of treating it is $116 billion annually. We treat it pretty well, but there are tangible things we can do in the areas of obesity, weight management, nutrition, fitness and health risk assessment to reduce the incidence of diabetes. We can cut that 57 million number in half and make a dramatic impact not only in the delivery system costs but in people’s lives.

Q. Your second point is more affordable health care. How do you translate that sweeping goal into something concrete when costs are steadily mounting for both businesses and individuals?