Robert Reich’s Blog: How a Few Private Health Insurers Are on the Way to Controlling Health Care — Reich, the former Clintonian, has been doing the work of the media now for a couple of years.

A system based on private insurers won’t control costs because private insurers barely compete against each other. According to data from the American Medical Association, only a handful of insurers dominate most states. In 9 states, 2 insurance companies control 85 percent or more of the market. In Arkansas, home to Senator Blanche Lincoln, who doesn’t dare cross Big Insurance, the Blue Cross plan controls almost 70 percent of the market; most of the rest is United Healthcare. These data, by the way, are from 2005 and 2006. Since then, private insurers have been consolidating like mad across the country. At this rate by 2014, when the new health bill kicks in and 30 million more Americans buy health insurance, Big Insurance will be really Big.

In light of all this, you’d think the insurance industry would be subject to the antitrust laws, so the Justice Department and the Federal Trade Commission could prevent it from combining into one or two national behemoths that suck every health dollar out of our pockets (as well as the pockets of companies paying part of the cost of their employees’ health insurance). But no. Remarkably, the Senate bill still keeps Big Insurance safe from competition by preserving its privileged exemption from the antitrust laws.

found by Aric Mackey




  1. arpie says:

    Pretty powerful argument for a public option, I’d say.

  2. Benjamin says:

    Perfect argument for letting insurance companies compete over state lines.

  3. dusanmal says:

    “Pretty powerful argument for a public option” – ie. let’s really get rid of that pesky competition once and for all.

    “Perfect argument for letting insurance companies compete over state lines.” – but Dem’s won’t let that happen as it would ruin nice plans of blaming the unregulated industry and grabbing the power.

    Open damn’ markets and introduce anti-trust regulations, limit the lawyers thievery and this alone will result in huge improvement.

  4. RTaylor says:

    What’s good for capitalism, must be good for the nation. If you disagree you are a terrorist and a dirty rotten commie.

  5. brm says:

    #4:

    Yeah, but the whole argument is that our existing broken health insurance industry *isn’t* a free market.

  6. tcc3 says:

    How will the “free market” handle a business that fundamentally isn’t profitable?

    How do you keep it from being a race to the bottom to cut services to enhance the bottom line. Gotta make those investors happy.

    The free market would say only the rich are entitled to be treated and be well and live. I guess the poor just shouldn’t get sick. Problem solved.

  7. RSweeney says:

    Perhaps those government regulations that restrict competition might be reformed.

    Nawww… didn’t think so.

  8. Shingo says:

    #3

    Yeah, because there’s competition already…

  9. deowll says:

    When most Americans think of health care reform they think of controlling costs and providing better and more service to more people.

    I’m not sure what this health care bill is about but all I can come up with is corruption and a power grab.

  10. chuck says:

    #2 – exactly right.

    But, it was the insurance companies’ lobbyist who got them protection from competition by not permitting cross-state insurance.

    Rather than “let” insurance companies compete across state borders, how about we “require” them to compete across state borders?

  11. Breetai says:

    Looks to me more like an argument pointing out the corruption of the lobby system.

  12. Phydeau says:

    The problem with competition in providing health care, is that they aren’t competing to provide you with the best health care. They’re competing to providing you health care at the lowest cost for them and the highest price for you that they can get away with. That’s just how capitalism works. And that’s why it’s not suited for providing health care.

  13. MikeN says:

    The insurance companies ‘work’ with state legislatures to make themselves the dominant insurer in a state. More regulations on insurance helps the big players.

  14. LibertyLover says:

    Remarkably, the Senate bill still keeps Big Insurance safe from competition by preserving its privileged exemption from the antitrust laws.

    Say it ain’t so!

    #14, I think you missed the point. Insurance companies are NOT competing. If they were, service would be better. Remove the anti-trust regulations!

  15. tcc3 says:

    They’re competing now. Aetna, Blue cross, Cigna and a number of others compete in each state. The lack of cross state operations means that each company operates fairly independently from state to state. If they are forced to offer services nationally we wont have 50 x # of insurance companies – well just have # of insuarance companies for all 50 states.

    I would also not be surprised to see them all move headquarters to a state with lax consumer protection laws or easily lobbied against governments – much like the banking and credit industry did.

    This will only change the scope by which they are cheating Americans. It doesn’t solve any of the problems of the current system.

    How can the “free market” handle a business that fundamentally isn’t profitable?

  16. tcc3 says:

    Also, how do you have them offer services nationally without some national regulations on health insurance? I know some folks are loath to have any more regs.

    The laws differing from state to state is part of the reason why they operate the way they do.

  17. MikeN says:

    and not suited for providing food, or shelter, or music, or movies, or labor.

  18. Somebody says:

    “Remarkably, the Senate bill still keeps Big Insurance safe from competition”….

    Really? How odd. How unprecedented. How Impossible!

    If if didn’t know better, I’d think that the whole point of regulation was to shield the fat-cats from competition. But that’s crazy-talk!

    The Current Deal:

    You keep voting for us; we’ll keep giving you the worst government you’ll tolerate.

  19. Rick Cain says:

    The whole “competing over state lines” is silly. its just a rightwing talking point.

    Fact is, insurance companies are national, and they do not compete with themselves. There are probably 30-40 state farm branches in my area, and you can transfer your policy to any branch without changing it one bit. That means its one huge monopoly, not 30-40 independent competitors.

  20. Somebody says:

    “How will the “free market” handle a business that fundamentally isn’t profitable?”

    Bankruptcy.

  21. Glenn E. says:

    Why do you think the “public option” was thrown out by Congress? Because it would have given the public a choice, other than these monopolist insurers! Big surprise, this option was so hotly contested, and the first thing to go. What will finally be approved (if anything) is a bill that hands billions of dollars over to these commercial insurers. For doing just as they’re doing now. Maximizing cost, while minimizing care. But soon, for all those that could afford to pay for it. Basically an Insurer Subsidy, protecting them from the lean years. They’ll still be calling the shots, as to how much they’ll allow you to be treated.

  22. Tenaya says:

    Henry VI got it all wrong. It should have been:

    “The first thing we do is kill all the lobbyists.”


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