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The American Medical Association, in a new report, shows that almost every single health insurance market in America is “highly concentrated”.
In 24 of the states, the two largest insurers had a combined market share of 70 percent or more. Last year, 18 of 42 states had that type of market situation.
Among the other findings:
• In 54 percent of metropolitan markets, at least one insurer had a market share of 50 percent or more — up from 40 percent of metropolitan markets the year before.
• In 92 percent of metropolitan markets, at least one insurer had a share of 30 percent or more — up from 89 percent of metropolitan markets the year before.
• Ninety-nine percent of metropolitan markets are highly concentrated, according to federal merger guidelines, compared with 94 percent the year before.
99% of all health insurance markets are highly concentrated. That hasn’t been seen in an entire sector since the Gilded Age.
When markets are highly concentrated, consumers have no choice but to accept extreme rate hikes, denial of benefits and other industry games. And that’s exactly what’s happened in recent years. The Affordable Care Act seeks to solve this problem by fostering competition in the exchanges, but without a renewed effort to break insurance monopolies throughout all insurance markets, including the large-group sector, consumers will continue to get screwed.
The President of the AMA, Dr. J. James Rohack, reacted to this report by calling on the Justice Department to enforce anti-trust laws prohibiting “harmful mergers.” Central to that would be a repeal of the insurance industry’s anti-trust exemption. A bill to that effect passed the House earlier this year. It has, say it with me, stalled in the Senate.
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David, Incredibly Good News!
I’m an so thankful to this Administration, to be required to participate, to donate.
I have no words
stalled in the Senate.
This Mandated Health Insurance is just another way that your politicians in Washington have reached into your pocket to pay off the corporations and pacs that have paid to put them into office.
This bill was never about health care. It was always about corporatism in government.
Having a middleman between you and your doctor that can and will decide if your ‘coverage’ will pay is simply more BS from D.C.. And now, in addition to the bloated insurance bureaucracy this will create, your Federal Government will create 2 more bureaucracy’s: One to “police” the insurance companies, and another to make sure that you pay these corporations — up to 16,500 new IRS agents to go after Citizens.
Our Government is so broken, so bought off by the corporations, politicians let them write the bills and pass the bills as quid pro quo for campaign contributions.
I say vote every incumbent out of office. Every one. Citizen’s will never regain any power in this country until we use our VOTE to SWEEP DC CLEAN of all of this nonsense.
Thanks David.
The AMA has been fighting against health care “reform” for decades. Are they now trying to point out a problem to restore credibility? The so-called “historical” health care bill does not change the inherent problems in our system. The only way to do that would have been to bring our country into the 21st century with a robust public option or single payer system (expand Medicare to Everyone). Until we get that reform, the damage our “health care system” does to citizens will continue.
Just remember who said the PO was “just a sliver” and then went on to kill it completely.
Anti-trust exemption removal was really the second most effective cost-control provision after Public Option. I am not surprised it is stalled in Senate because of that.
Also complete: division of the progressive community into two camps. There are the folks here, most of whom feel royally reamed and ready to start a new party.
Then there are the people at the corporate-progressive blogs, who have opted to pretend the healthcare bill is a great progressive triumph and that Obama is a Democrat. I truly envy them their
hysteriaeuphoria. I don’t know what the percentages are (is it 50-50 or what?), but it’s definitely bad news for both camps.Chicago Blue Dog No. 1
How about forcing the insurers to actually compete by allowing people to choose from any plan in the country — while removing the anti-trust exemption (hello harry reid… the bill is waiting for you…)
Obama, Pelosi and Reid could have gotten that passed as part of the combined health bill… but the $474 billion health insurance company bailout bill (over 6 years mind you) only had big lobbyists in mind, not actually the American people.
This is complete reichwing propaganda bullcrap. They may hire up to 8,000 new paper pushers, and they will mostly be handing out rebates and credits. They are forbidden by law from using tax collection methods to go after those who don’t have insurance.
(from Think Progress and FactCheck)
There is a pot/kettle aspect to this story. It’s very much in the AMA’s interests to keep pointing the finger at market power in the insurance industry. The last thing AMA wants is a powerful insurance industry capable of imposing market power in negotiating rates paid to health care providers.
Meanwhile the concentration of hospitals and associated doctors, and the ties between doctors and clinics/labs/hospitals continue, creating provider market power, conflict and related anti-trust problems.
Shocked! Shocked! Nobody noticed this before? Like Condi Rice’s total surprise that someone would fly airplanes into tall buildings.
The only good news is this is such an obvious payoff and will fail. Then maybe we can get a real solution. Single Payer..
The AMA was the first and most enduring lobby against developing rational health care policies. Hell. Some even opposed insurance. But I have to say they have had some change of heart recently. Certainly rank and file physicians now in the majority favor some kind of single payer/govt option. The ought to.
That’s the good news, of course, if you’re expecting a refund check …
The exclusion from anti-trust only applies to insurance companies.
The fact that anti-trust does apply to even sole proprietor physicians has been a great hindrance to physician participation in developing many cost saving programs at the local level. That was left to the corporate sector. And you see what we have.
“This bill was never about health care. It was always about corporatism in government.” Corporatism such an ugly phrase. The PR flacks for Big Biz and BIG Gov’t have their own more friendly phrase, “The Public / Private Partnership.” It’s Orwellian for CORRUPTION, another ugly word that will be disappeared down the coming memory hole the big Corp. Internet Service providers will soon be erecting to get rid of all these pesky bloggers that dare speak truth to power. ( another nasty phrase that will also soon disappear.) The court ruling the other day against the FCC could be all of our swan songs and soon!
shuh. not that I was rooting for ‘em, but good gaia HCR as passed, presented them with a boatload of platinum, diamond encrusted talking points for mid terms . . . and what do these hapless nine year olds do with it ? do they ‘build’ their way to November, oh hell no, they jump right of the box with “IRS Agents at your door – booga booga !”
they would mess up a wet dream
apologies to nine year olds everywhere
Mornin’ All :D
This provides a real opening for the Democrats, if they seize it. I would bet a fair amount of money that only a small minority of the public have an inkling as to how monopolized the health insurance industry is. It would not be rocket science for the Dems to mount an anti-monopoly campaign to get the anti-trust exemption removed. Takes balls, of course, given that too many senators are in the company’s pockets, but it is good politics and good policy. The decision has to made at the top, but if Obama were to stump for it, I think he would win.
That’s crazy talk. Health care costs don’t have anything to do with doctors and hospitals. It’s all the evil insurance companies fault.
I’m in the camp that this is better than nothing. With several adult children w/ pre-existing, and as a self employed person, I am hoping it is just a start. Getting off the dime on this and continued pressure to enact progressive revisions to fix over time seems to me to be the only way to get to what we were hoping for, and that would eventually be single payer. The powers that be fought against this “modest” reform so strongly that maybe we got a foot in the door. If we all have to pay the insurance companies now, and we all find that rates keep going up, there will be further calls for action and replacing some of the bought and paid for senators might enable that change over time. Removal of the anti-trust exemption would be a good start.
I am not particularly enamored of the new law, but 8,000 jobs in this economy is 8,000 jobs. It’s like the census worker jobs, puts real money in real pockets and real food on real tables.
New post up top…
http://economistsview.typepad.com/economistsview/2010/04/doctors-with-ownership-in-surgery-center-operate-more-often.html
Well, I guess.
And those real pockets do belong to real people so that’s good for them. But since we’re talking about government jobs, that real money is coming out of your real pocket.
I don’t know the solution to this, but the Senate needs to be abolished, and restructured so it WORKS for US. WTF happened to majority rules???????
I’m not sure there is a way out of this mess. The laws that need to be passed to make it illegal to lobby, and/or take any private funding/donations, and to make ALL (including judicial) elections FULLY publicly funded will never get passed by this horrible excuse for a Senate.
With that said, I think this country is sunk. I think we are going the way of all other great civilizations. We are over sexed, over religious, over righteous, and under educated, under healthy, and under reasonable as a populace. Sorry for the doomsday, but seriously…I don’t see the way out.
There are a lot of other government things that come out of my real pocket that I would rather not pay for than jobs. Rescuing the banksters so they can continue to pay big bonuses and refuse to lend comes to mind.
I think that Majority Rules is still functioning, but only when it’s convenient and the head fellow wants them to
scarecrow— simply saying that docs who participate in surgery centers operate more often means little —
1. docs who are busier with more surgical based practices are much more likely to see that an investment in a surgery center is a worthwhile investment.
2. costs at surgery centers are a small fraction of the costs of the same procedure at a hospital.
3. disclosure rules exist — so patients can always go to someone else if they think the surgery is being “pushed” on them for money.
4. AMA has been saying this about health insurance company consolidation for YEARS — this is nothing new — remember that docs who are under continuous threat for violating “anti-trust” (even telling a colleague how much you get paid by another private health insurer for a procedure is against federal law) — so AMA has been against excessive market consolidation for years.
Agreed.
But if we call taking money from you and giving it to other people to push papers Jobs, then there should be zero unemployment (as long as you still have some money to give up).
Alan, I need a job. Would you be willing to donate more thru your taxes, so that I could have a paycheck?
msmolly – I understand your argument and I’m with you, sort of. Just taking it to a ridiculous extreme.
Didn’t the GOP beg to have these markets opened nationally so that many companies could compete in every state? Wasn’t this dismissed as “ineffective” and worse?
This could have easily been fixed!
So would 8,000 new prison guards be a good thing as well?
Oy.
They had the past year focused completely on health care reform and transformed it into health insurance bailout. The opportunities to raise issues of that nature were too numerous to count…and they passed on them all.
What will it take for people to understand that this sort of thing didn’t happen because Obama and the Democratic leadership didn’t want it to happen?
THANK GOD FOR SCARECROW!!
I’ll add onto your post. Ever heard of Bayonne Medical Center? They were a HORRIBLE hospital in NJ that locals wouldn’t go near. Then they were bought by a Private Equity firm and started turning around 20% profits. Here’s how.
http://www.bayonnecommunitynews.com/view/full_story/4163667/article-Moving-ahead-Bayonne-Medical-Center-on-the-mend-%E2%80%93-despite-problems-
so basically BMC purposefully dropped out of every insurance network. Told patients to STILL come there and waived all their insurance deductibles and copays. They billed at UCR rates which are much greater than a network fee.
And people wonder why healthcare costs are going up.
How do you go in 1-2 years from being bankrupt, hopelessly in debt to turning a 10+ million profit? On the backs of my premium that’s how.
If I remember Gov Dean once said Public Option was the reform and when I heard it he said in words what I was thinking it was and I totally agreed. It was the simplest and cleanest way to bring down costs while still holding the market model.
Next best thing was Anti-trust exemption removal so that competition can be created and prices brought down. Please note this was something which Republicans too agreed if I remembered their quotes. I wonder who is holding up this part in the senate. Is it those lobbyists who version became the final bill ignoring the work of 4 house committees and other senate committee.