New Report: Private Insurance Mergers Lead to Near-Monopolies Across the Country

Below was taken from The Website Health Care for American NOW -
I feel this information is so important it should be posted everywhere. We need to be informed and involved in order to effect a change.

Sen. Schumer and Health Care for America Now Warn of Private Insurers’ Monopolies; Former US Antitrust Official Calls for Investigation


Washington, DC – Senator Charles Schumer (D-NY) joined Health Care for America Now (HCAN) – the nation’s largest health care campaign – in releasing a new report today that shows extreme health insurance industry consolidation has resulted in a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate. As a result, health insurance premiums have skyrocketed, going up more than 87% - on average - over the past six years.

“This is the starkest evidence yet that the private health care insurance market is in bad need of some healthy competition,” Senator Schumer said. “A public health insurance option is critical to ensure the greatest amount of choice possible for consumers. We believe that it is fully possible to create a public health insurance plan that delivers all the benefits of increased competition without relying on unfair, built-in advantages. If a level playing field exists, then private insurers will have to compete based on quality of care and pricing, instead of just competing for the healthiest consumers.”

After reviewing the report entitled “Premiums Soaring in Consolidated Health Insurance Market,” David Balto, former Policy Director of the Federal Trade Commission and now a Senior Fellow at the Center for American Progress, sent a letter -co-signed by HCAN - to the Department of Justice Antitrust Division asking for a comprehensive investigation into the health insurance marketplace.

"The HCAN report provides a much needed spotlight on health insurance markets, and what it found is a toxic marketplace where competition and consumers suffer,” said Balto. “Unfortunately, antitrust enforcers have been asleep at the switch for the past several years and have permitted health insurers to acquire monopolies in dozens of markets. Consumers have paid a steep price for this merger mania in higher prices, deceptive and fraudulent practices, and ultimately assembly line health care."

In the past 13 years, more than 400 corporate mergers have involved health insurers, and a small number of companies now dominate local markets but haven’t delivered on promises of increased efficiency. According to the American Medical Association, 94 percent of insurance markets in the United States are now highly concentrated, and insurers are thriving in the anti-competitive marketplace, raking in enormous profits and paying out huge CEO salaries. Profits at 10 of the country’s largest publicly traded health insurance companies rose 428 percent from 2000 to 2007. In 2007 alone, the chief executive officers at these companies collected combined total compensation of $118.6 million—an average of $11.9 million each. That is 468 times more than the $25,434 an average American worker made that year. Moreover, the health insurance industry invests more in buying back its own stock and rewarding its shareholders than in improving system operations, reducing premiums, or in developing ways to pay doctors and hospitals fairly.

"To try to reform healthcare in the current market structure is like setting sail across the Atlantic on a raft," Balto added. He noted while renewed antitrust and consumer protection enforcement is essential, it is not sufficient to begin to restore some semblance of a functioning market. Only a public health insurance option will be able to force private insurance companies to adopt new pro-consumer policies.

“Talk about an unfair advantage,” said Richard Kirsch, National Campaign Manager, Health Care for America Now. “There is nothing more unfair than the way the current monopolistic private health insurance market controls both cost and coverage. The Antitrust Division of the Department of Justice should take a long, hard look at the way this industry operates. It needs rules. It needs regulation. And most importantly, it needs real competition from a public health insurance option.”

“It will be extremely difficult to return competition to the farm after the barn door has been left open,” Balto explained. “Insurance companies will fight tooth and nail against any antitrust or consumer protection enforcement, and they have the monopoly profits to fund a One Hundred Years War of litigation.”

Contact Jacki Schechner for call information at jschechner@healthcareforamericanow.org or 202-454-6196. For more information about Sen. Schumer call Brian Fallon 202-224-8346.

PLEASE Note:

This report makes use of data published by the American Medical Association, which is not a member of the Health Care for America Now coalition and did not collaborate with HCAN on the writing or research presented here.

The AMA data presented in this report included figures for both statewide areas and metropolitan statistical areas. All data for self-insured employer-sponsored plans refer to preferred provider organizations (PPOs), not combined data for health maintenance organizations (HMOs) and PPOs.

HCAN attributed the following statement to the AMA in individual state reports: “The American Medical Association reports that the number of health insurance companies has declined by nearly 20 percent since 2000, and as a result 94 percent of insurance markets in the United States are now highly concentrated.”

This sentence should have the following footnoted citations:

David Balto, “The Right Prescription? Consolidation in The Pennsylvania Health Insurance Industry,” Senate Judiciary Subcommittee on Antitrust, Competition Policy, and Consumer Rights, July 31, 2008. Accessed at http://www.americanprogressaction.org/issues/2008/balto_testimony.html;

American Medical Association, “Competition in health insurance: A comprehensive study of U.S. Markets: 2008 update.”

Please JOIN: http://healthcareforamericanow.org

PRIORITY "Reality Check"

I titled this post using these words because things happen in life that trigger a reality check of what is deemed a priority. This is happening to me right now. It just so happens, that the name of my company (actually mine & my husband's company - Bamboo Balance) materialized from combining his love of bamboo (and it's strength) and my belief in the importance of living a balanced, healthy life. Seemed like a great way to choose a name of a company that focused promoting simple, healthy, fit living.

Well... as of late, our lives have been thrown way off balance and "simple" it has not been. This all has absolutely nothing to do with the manic gas prices or the state of our nation or anything of a "global" nature. It is totally about my world and what is happening in it right now.

I have always believed that things happen in life for a reason. This is why I am struggling while searching for one at this moment in time. All I have come up with is this... Right now I am due for a - Priority "reality Check". And what is that? It boils down to this question....What is truly important in life? What is a Priority? For me - The answer is - Relationships. Relationships with those you love tops the list...my order is - family, friends and beyond that acquaintances, those we meet and take interest in - even those we don't meet (personally) but somehow care about anyway (this includes animals too). Family is top rung in my world, and in my opinion if you don't have that "familial" thing going on - it is truly a great loss in what can help provide balance when the tipping point comes and you're about to fall.

Most recently, a tragic medical mishap (that's being nice) occurred in our family (specifically my husband's mother). It has completely turned life up side down for us, as a domino effect can when a situation like this befalls a family member.

On July 23rd my very healthy seventy year old mother-in-law went to have a routine procedure done by her doctor as a preventative measure as suggested by of course, him. We are all familiar with after hitting the 50 year old mark, a colonoscopy test seems to be the "dreaded" test that now has become commonplace to get. This was my mother-in-law's fourth time having this done (preventative measure) so she was extremely familiar with the preparation protocol as required, prior to having the procedure done. What she certainly was not prepared for, was the result of 12 days later being in the ICU of the hosp (1 week so far at this writing), hooked up to machines that are allowing her to continue to survive, while the medical staff is trying to figure out what is wrong. Imagine...All this from a "routine" medical procedure that is suppose to be a preventative measure.

Mom's colon was ruptured during the test- this resulted in immediate emergency surgery having to be performed to repair the perforation. Fortunately, she was under anesthetic and felt nothing, however when she awoke, instead of preparing to leave the doctors office, she was lying in a hospital bed in pain, wondering what the hell just happened to her. What initially seemed like a successful repair of the damage and a hospital stay of four days to recover - turned into a fiasco with each passing hour. She progressively became worse (due to an infection occurring), this resulted in her having to be transferred to the intensive care unit. Her breathing became labored, she "coded" and had to be revived ,hooked up to a respirator ( a tube shoved down her throat) because her lungs failed, she went into renal failure and now needs dialysis daily and the nightmare goes on and on. She has so many bottles & bags dangling around her, tubes going in and out of her body, machines beeping and numbers flashing monitoring her systems as the doctors struggle to keep her alive and to best of their ability get her well.

My husband, being the eldest of two sons, takes personal responsibility for his mother and her care. She is the only parent he (and his brother) are left with. His dad died almost four years ago and my husband still continues to feel that loss everyday. His mom is his priority and her medical care is of the utmost concern and importance to not only him, but the entire family extending far and wide. So needless to say, he has spent many hours by her bedside forsaking everything else in life that is also deemed a "priority" (work, sleep, assorted projects etc...). We are self employed and our business revenue depends on providing a service, so taking any time away from providing that is a tremendous sacrifice of income for our family. With this crisis however, not a thought of doing anything different but being there for his mother ever crossed my husband's mind, she comes first - that's his priority. I never had a second thought of him doing anything different and that became my priority. After this week of not working and dealing with hours of medical jargon, and bedside hours - it sends you into a frenzy. So for the sake of some sense of normalcy and the reality of having to pay the mortgage he had to go back to work. So now my husband's time is split between working, then driving 25 miles to the hospital, spending late hours there (getting little rest & food) and repeating it the very next day. My role is to keep all the balls in the air and not let them drop and break into a million little pieces. I always look up....

That is a priority reality check.

When it comes to the question of who will do the right thing and be accountable for this horror show...WELL... I can only hope that the Doctor(s) and Hospital own up and take responsibility. Yes we are human and human beings do make mistakes, however, we are not blind to the fact that this was all a result from something that went terribly wrong after she walked through the doctor's office door to have a routine colonoscopy procedure done on July 23rd.

This domino effect which began with good intention to do something right to care for the betterment of health and life longevity, has turned into the most unfortunate of circumstances effecting many lives in an extremely devastating way. It will leave it's mark on our family for a long time, if not forever. It would be nice to hear an apology and hope that the medical community has a heart and a priority to the care of the patient and not to greed and the "almighty dollar". All we ask is for everyone connected with this medical situation DO THE RIGHT THING...that's all.

We can only now just keep the faith and know where our priorities are.

Till the next time.....