It will be clear Monday to the state superintendent of insurance, if it is not already, that the proposed sale of Blue Cross and Blue Shield of Maine to Anthem Insurance Co. is unacceptable to a significant number of Maine doctors and professional groups in health care. The reason for their rejection has less to do with the narrowest definitions of law and more broadly with their understanding of what is fair and equitable — including the proposed selling price of this public asset — to the people of Maine.

The officers of Blue Cross and Blue Shield might not have known before the announcement of the sale how deeply appreciated their work was in Maine, but they know it now. The Maine Medical Association, Maine Osteopathic Association, Maine Psychiatric Association, Maine Public Health Association and a half dozen other medical, labor and advocacy groups have opposed the sale because they believe service from Blue Cross under it will worsen, prices will rise and the number of people denied access to health-care coverage will increase. The groups came to these conclusions after many months of research and debate.

Maine Insurance Superintendent Alessandro Iuppa will hear from intervenors beginning Monday, and rather than a long list of sins committed by Anthem in other states — although there may be some of those — he will likely hear what Maine stands to lose if this sale goes through. For instance, Maine could lose an understanding of the kind of health care choices its residents value, including challenges specific to rural health care. And the loss of a nonprofit to what soon may become a for-profit company could raise prices — an issue of particular importance in determining the fairness of the sale of this public asset.

He will also hear about the price tag on the deal. Despite Blue Cross’s $17 million operating loss last year, the company has increased its number of subscribers considerably as Tufts and Harvard Pilgrim health plans have failed or are failing. They are not alone. Rhode Island Blue Cross has seen gains after rejecting Anthem’s offer due to these changed circumstances, as has Massachusetts Blue Cross.

Even if the original price of $120 million for Blue Cross were accepted, and there is some doubt about that, these abrupt and significant alterations to Maine’s health-care landscape since the offer mean that the terms of the proposed sale should be renegotiated. And the state expected to see a charity foundation of between $90 million and $100 million as a result of the sale; the net proceeds to the foundation now are down to less than $82 million. The superintendent’s difficult task is to ensure that both the price and the foundation are adequate and that no portion of the deal is contrary to Maine’s interest.

The public’s equity in Blue Cross has been built up over six decades. More than arguments over market share and profit v. nonprofit organizations, the antipathy toward the sale is based on the belief that something Maine has supported and been supported by will disappear as Blue Cross becomes part of just another large corporation. Economies of scale count, but they are not much good to the doctor who spends too much of his or her day fighting to get answers from an insurer; and they are even less useful to the patient waiting and waiting for those answers.

Tellingly, Anthem lawyers have worked to ensure the sale is considered by the state only in the narrowest business terms. And while all businesses have a bottom line, the bottom line for nonprofit health-care companies has been service to the public. If the sale process is an indication, it seems that Anthem will be changing that, if not now, then in a couple of years.