The Projo editorial board’s comments on recent healthcare happenings in the state mention a strategy — perhaps a necessity — with much broader application:

We are unmoved by Blue Cross’s complaint that United is “an out-of-state for-profit company.” In all-too-cozy Rhode Island, being out-of-state can be an advantage, avoiding as it does the local cronyism that has characterized such creatures as Blue Cross & Blue Shield of Rhode Island.
And calling Blue Cross a “not-for-profit” merely elicits a bitter chuckle. We immediately think of the conflicts of interest — the most glaring being that Blue Cross Board Chairman Frank Montanaro also heads the state AFL-CIO.

As a conservative advocate (of sorts) in this state, I can confirm that outside help is just about the only hope for real change at a pace measurable in years rather than decades. Fortunately, just as the size of the state helped its problems to develop, it lessens the degree of attention required from wider-world groups. (Of course, for them to care at all, we’ve got to be laboring from within.)