Blue Cross Blue Shield dominates N.C. health insurance markets [Winston-Salem Journal, N.C.]
|By Richard Craver, Winston-Salem Journal, N.C.|
|McClatchy-Tribune Information Services|
The products included health maintenance organizations (MCO), preferred provider organizations (PPO) and point of service plans (POS).
The AMA said it determined, as it has in the past, "a significant absence of health insurer competition" in 70 percent of the 385 metropolitan areas it surveyed nationwide.
"The new data demonstrate that most areas of the country have a single health insurer with an anti-competitive share of the HMO, PPO or POS market," said Dr.
The study said that health insurers' monopoly power in markets produces increased premiums, watered-down benefits and insurers' growing profitability. The study these "as evidence that highly concentrated markets harm patients and physicians."
Competitors have been making some market-share gains in
The study determined
However, for strictly PPO products,
"This annual study shows that
Among the study's findings: 67 percent of the metropolitan areas had a health insurer with an HMO market share of at least 50 percent; and 68 percent of the areas had a health insurer with a PPO and a POS market share of at least 50 percent.
The insurer reported a
Although rates are regulated by the state insurance department, the
The health insurance industry "is leading us toward a few, super-large underwriters who control the market," said
The primary reason there is a lack of competition is that insurers are regulated and licensed in each state's insurance department. That's why
Some states require more mandated benefits and coverage, which is why premium costs tend to be higher and why consumers aren't allowed to buy insurance across state lines.
"Insurers, like all businesses, want to operate where they have a favorable business climate," said
"I would like for someone to explain why there is a lack of insurers interested in entering the health care insurance arena in
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