It’s not known what, precisely, is meant by “sufficient competition,” but whatever it is, it’s not what exists today in the health insurance market in most metropolitan areas. Want to see that in a chart? Of course you do!
Masthead
Editors in Chief
Austin Frakt
Aaron Carroll
Managing Editor
Adrianna McIntyre
Contributors
Kevin Outterson
Bill Gardner
Nicholas Bagley
Other ContributorsRecent posts
- Does Vitamin D Influence Mood?
- How Useful Are Temperature Screenings for Covid?
- Veterans Experience Differences Between VHA and Community Providers
- The Health Of The People Should Be The Supreme Law
- What Can Be Learned From Differing Rates of Suicide Among Groups
- At-Home Testing for Covid
- Bias In, Bias Out
- Come work with me (and colleagues you’ve read here)
- Covid Vaccine Facts with the WHO’s Dr. Kate O’Brien
- Nest Protect and the nuclear option
Archives
For speaking inquiries
Interested in having Aaron or Austin speak to your group?
For information on Aaron speaking, click here.
For information on Austin speaking, contact the Leigh Bureau.
Aaron’s stuff
Selected appearances:
The Colbert Report
Good Morning America
Sound Medicine (most recent)
The Ed ShowAustin’s stuff
Click here for links to Austin’s peer-reviewed publications and/or related posts.
Bonus chart of the day: Will competition in exchanges be sufficient?
04/11/2013
Austin Frakt
item.php
Follow the blog
TIE Books
Amazon.com
Barnes & Noble
Indiebound
iBooks
Google
Kobo
Amazon.com
Barnes & Noble
Books-A-Million
iBooks
IndieBound
Powells
Buy at Amazon.com
Summary
Excerpt: Economic profit
Excerpt: Diminishing marginal utility
Excerpt: Four factors of production
Excerpt: Monopoly marginal revenue
Excerpt: Consumer/producer surplus
Amazon.com
Barnes & Noble
Books-A-Million
Borders
IndieBound
Powells
Borders
Barnes & Noble
IndieBound
Amazon.com
Books-A-Million
Powells
Austin and Aaron are participants in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.Tag cloud
ACA AcademyHealth access accountable care organizations Affordable Care Act announcement blogging cancer comic competitive bidding costs cost shifting COVID-19 employer-sponsored health insurance health care costs Healthcare Triage health insurance health insurance mandates health reform hospital readmissions hospitals individual mandate insurance exchange market power Massachusetts Medicaid Medicare Medicare Advantage mortality nutrition obesity On The Record physicians politics PPACA premiums prescription drugs quality reading list reflex RWJF spending uninsured Upshot vaccines
by Alsan on April 11th, 2013 at 17:47
Yes, the chart pretty well shows that one of the problems with healthcare in America are highly concentrated geographic markets for health plans. The answer is to tighten and enforce the antitrust laws, i.e., work to decentralize economic power in these markets. We’re going in precisely the wrong direction.
by Brad F on April 11th, 2013 at 20:17
Do you tame the beasts via selective contracting and active purchasing via states or feds?
The old saying:
When you control 25% of the market you negotiate with suppliers. When you control 80% of the market, you send them an email with the numbers they will get.
You get the idea.
New MCOs wont sprout. Heavy hand in some way must intervene to move things forward.
Brad
by Jonathan on April 11th, 2013 at 23:45
Wait, what? We know that markets with a lot of insurers actually correlate with higher prices, because hospitals use their market power more effectively and demand rate hikes. Since we do not operate in a normal market in healthcare, but instead one driven by emotion that is relatively nonresponsive to the cost of care (in part because prices for care are unknown to consumers), sufficient competition among insurers can’t be gleaned by looking at a chart like the one in the post.
Also, it isn’t just about the number: there are industries with just 3-4 players that dominate yet prices are kept under control, customer satisfaction is high and innovation occurs. If the argument is that more insurers will lead to more satisfaction or innovation, despite higher costs, maybe, but we do have dozens of insurers with more than a billion dollars of revenue each year. There is less industry concentration among insurers than cell phone makers.
In terms of local market dominance, which the chart purports to show, we shouldn’t forget that in addition to fully insured commercial business there is Medicare, Medicaid and self-insured commercial business. I doubt the chart from the AMA(!) reflects that. An individual consumer doesn’t typically get to pick between these types of coverage, but it does complicate the picture of market dominance.
Cell phone networks or cable companies would be far better examples of insufficient competition and its adverse effects than health insurers.