Monopoly in Health Insurance Hurts Employers, Consumers and Doctors



How do you feel about your health insurance? Fasten your seat belt. More problems have unveiled in America’s healthcare system.

Patients, physicians and employers have been in the same boat – skyrocketing health insurance costs from a lack of competition exacerbated by ObamaCare. ObamaCare has mandated fewer choices in insurance coverage, and choices of doctors and hospitals.

Now comes an eye-opening study by the American Medical Association (AMA). It shows one health insurance company holds a monopoly — one of the many quagmires associated with ObamaCare.

ID-10033362 photostockThe 2014 study shows WellPoint, being renamed as Anthem, is the biggest health insurance company in 82 of 388 U.S. markets.

“The AMA is greatly concerned that in 41 percent of metropolitan areas, a single health insurer had at least a 50 percent share of the commercial health insurance market,” said AMA President Robert M. Wah, M.D.

This doesn’t bode well for employers, consumers and doctors.

False promises

You might recall President Obama and his supporters made several claims that have proved to be false –including ObamaCare would allow patients to keep their doctors and that they would pay lower premiums.

But that hasn’t been the case. As feared when the law was furtively passed, it has resulted in anti-competitive prices, lack of choices, and/or substandard payments to doctors. This means poorer healthcare services.

It’s been exacerabated by a monopoly — Wellpoint owns 50 percent of the health-insurance market in 41 percent of U.S. markets. The company’s dominance is more than twice as big as its largest competitors, Health Care Service Corp. and UnitedHealth Group (UNH).

Health Care Service Corp. was second with a market share lead in 37 metropolitan areas, followed by UNH with a market share lead in 35 metropolitan areas.

Hurts competition

“The dominant market power of big health insurers increases the risk of anti-competitive behavior that harms patients and physicians, and presents a significant barrier to the market success of smaller insurance rivals,” said Dr. Wah.

The report found that nearly three-quarters of the metropolitan areas in the report are “highly concentrated,” lacking insurer competition.

More key findings:

— A significant absence of health insurer competition was found in 72 percent of the metropolitan areas studied.

These markets are rated “highly concentrated,” based on the guidelines used by the U.S. Department of Justice and Federal Trade Commission to assess the degree of competition in a given market.

— Seventeen states had a single health insurer with a commercial market share of 50 percent or more.

— Forty-five states had two health insurers with a combined commercial market share of 50 percent or more.

— The 10 states with the least competitive commercial health insurance markets were: 1. Alabama, 2. Hawaii, 3. Michigan, 4. Delaware, 5. Louisiana, 6. South Carolina, 7. Alaska, 8. Illinois, 9. Nebraska and 10. North Dakota.

Illinois has made its first appearance in the annual AMA list, displacing Rhode Island from last year’s list. Louisiana entered the top 5, moving from 9th on last year’s list.

–The 10 states that experienced the biggest drop in competition levels between 2011 and 2012 were: 1. Illinois, 2. Louisiana, 3. Indiana, 4. New Jersey, 5. New Hampshire, 6. Vermont, 7. Montana, 8. Wyoming, 9. Idaho and 10. Tennessee.

From the Coach’s Corner, related information:

Healthcare Crisis – What the Plight of Doctors Means to You — America’s shortage of doctors is a widespread concern, and the stories you’ve heard about the difficulties experienced by doctors are true. Their difficulties were aptly explained by a study mentioned in an article published by Medscape Medical News.

Inefficiency, Fraud in Healthcare and Insurance – How You Can Help — Inefficiency and fraud in healthcare and insurance has generated a ton of headlines. So a discussion about inefficiency and fraud has to include all stakeholders. That means patients, doctors and insurance companies – all must get a square deal for the healthcare system to work. But it appears doctors are experiencing unnecessary challenges.

FDA Inefficiency Costs ‘Thousands of Lives and Billions of Dollars’ in Healthcare – Book — ObamaCare is one of the biggest financial headaches suffered by businesspeople. But there’s more bad news for business. Now, a book indicts the Food and Drug Administration (FDA) for massive problems that annually lead to the deaths of nearly a quarter of a million Americans and cost an unnecessary $200 billion+ in healthcare expenses.

Fiscal Fact-Check: Deficit, Social Security, and Medicare — America’s economic system is in grave danger. Like your personal finances, fiscal discernment in U.S. public policy is important for our economic recovery. A Harvard study reveals that massive U.S. borrowing and spending have wasted trillions of dollars in flawed efforts to stimulate the economy.

Nothing drives change like a shortage of cash.

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Author Terry Corbell has written innumerable online business-enhancement articles, and is a business-performance consultant and profit professional. Click here to see his management services. For a complimentary chat about your business situation or to schedule him as a speaker, consultant or author, please contact Terry.

Photo courtesy of photostock at www.freedigitalphotos.net

Seattle business consultant Terry Corbell provides high-performance management services and strategies.