Today's N&O features a very unsurprising article about Blue Cross Blue Shield's dominance in North Carolina's health insurance industry.
marketplace competition for insurance, a coalition of employee and civil rights
groups released data Wednesday showing a near monopoly of coverage already in
Two companies, Blue Cross Blue Shield of North Carolina and UnitedHealth
Group, control 73 percent of the state's private insurance policies. Blue Cross
alone has a 53 percent share.
Left out of the article is the obvious question: How does such a large industry come to have so few competitors?
It couldn't be that government regulations, mandates and restrictions had anything to do with it, could it?
The state dictates precisely what conditions and services must be included in every policy, denies access to insurance plans from out-of-state, and prohibits risk-pooling such as association health plans. Not to mention the federal government's unequal tax treatment of employer-provided coverage compared to individually purchased plans. And that's just off the top of my head.
All of these oppressive rules and restrictions establish high barriers to entry, which greatly discourages new entrants into NC's health insurance field; serving to further entrench the insurance giants already in place. No significant monopoly or oligopoly has ever existed long without the iron fist of government intervention.
But the intellectually uncurious N&O reporter decides that learning and explaining some of the causes of BCBS's dominance is not worthy of column space.
If the health insurance market were left largely unfettered, we would
see much more healthy competition for our health care dollars,
resulting in more choices, higher quality and lower costs.
On a somewhat related note, why is there no such concern from civil rights groups about "marketplace competition" when it comes to K-12 education? Just imagine the first two paragraphs re-written:
"..a coalition of employee and civil rights
groups released data Wednesday showing a near monopoly of coverage K-12 education already in
North Carolina.Two companies, Blue Cross Blue Shield One institute, the state government of North Carolina and UnitedHealth
Group, controls 73 100 percent of the state's private insurance policies K-12 education for those who can't afford to pay for private schools in addition to their taxes."