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Competition in Health Insurance - March 20, 2011

posted Mar 20, 2011, 9:21 AM by Terry Shilling   [ updated Mar 20, 2011, 12:45 PM ]
In preparation for a speaking engagement, I had an opportunity to review the most recent Competition in health insurance study published by the American Medical Association (AMA). Even as a person who has been involved in health care for a long time on both the payer and provider sides, I find the results of the study quite remarkable. 

The authors of the study conclude the following:
"Virtually all commercial health insurance markets in the United States are highly concentrated. These markets are ripe for the exercise of health insurer market power, which is detrimental to society."

It doesn't matter if you agree with the comment regarding whether an oligopoly per se is detrimental to society, it's easy to see why the AMA is concerned. Below is a table showing the top 15 most concentrated States. Data is from January 1, 2008 and includes both HMO and PPO products.

State Largest Insurer Market Share %
Alabama BCBS AL 93
Alaska Premera 77
Iowa Wellmark 77
Hawaii BCBS HI (HI Med Serv) 75
Illinois BCBS IL (HCSC) 72
Tennessee BCBS TN 70
Idaho BC ID 69
Rhode Island BCBS RI 69
Michigan BCBS MI 68
South Carolina BCBS SC 67
Mississippi BCBS MS 66
Nebraska BCBS NE 66
Arkansas BCBS AR 57
Massachusetts BCBS MA 57
Virginia WellPoint 57


Please let me know what you think. The entire study is available for purchase from the AMA.