Blue Cross and Blue Shield of North Carolina has turned to farm animals to improve its image. The state's largest health insurer on Wednesday began a major, multimedia marketing campaign to emphasize that many parties contribute to rising healthcare costs. The stars of the ads: goats. A goat with a stethoscope, a goat in a suit and tie, a goat in a Hawaiian shirt. The tag line: Let's stop looking for scapegoats. The Chapel Hill company also started a website, www.letstalkcost.com, to spur more discussion. The message is that insurers, doctors, hospitals, drug companies, lawyers and consumers must work together to reduce healthcare costs. But the ads are likely to spark a backlash among some consumers, physicians and others who question why a nonprofit with $5.2 billion in annual revenue needs to spend even more money on marketing.