Consolidation among health insurers is creating near-monopolies in virtually all reaches of the United States, according to a study released Monday.
Data from the American Medical Association show that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under U.S. Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.
The study also shows that in 166 of 294 metropolitan areas, or 56 percent, a single insurer controls more than half the business in health maintenance organization and preferred provider networks underwriting.
"This problem is widespread across the country, and it needs to be looked at," said Jim Rohack, an AMA trustee and physician in Temple, Texas. "The choices that patients have now are more difficult."
Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they're also the biggest purchasers of health care and can dictate prices and coverage terms.
It also makes it harder for new carriers to emerge, as pricing already has been set by the dominant carrier.
The AMA says it has taken up this antitrust issue with the Department of Justice, but says it has run into roadblocks with regulators. AMA officials say regulators seem uninterested, even though government officials are more than willing to target doctors' groups and hospitals on antitrust matters.
Justice Department officials did not respond to requests for comment.
Well, surprise, surprise. The Justice Department is on the side of big business and big profits at the expense of the common welfare of Americans. Who knew?