At the Senate Judiciary Committee’s Sept. 6 hearing “Examining Competition in Group Health Care,” Mark Piasio, MD, president of the Pennsylvania Medical Society, testified that many large Pennsylvania health insurers are generating “huge profits” even as the state’s physician payment lags behind other parts of the country and premiums rose by 40% from 2000 to 2004. And the current merger of the two largest Pennsylvania health insurers will increase the statewide market share of commercial health insurers “to levels that would not be permitted under existing Department of Justice and Federal Trade Commission merger guidelines,” Piasio said. Edward Langston, MD, chair-elect of the American Medical Association, warned that “our worst fears are being realized in many markets across the country” and called upon the DOJ to subpoena health plans to determine whether they are engaging in anticompetitive behavior “to the detriment of consumers--our patients.”
But Stephanie Kanwit, special counsel to America’s Health Insurance Plans, argued that vigorous competition in the healthcare industry has spurred the introduction of new consumer products and that health plans are increasing market competition by promoting quality and transparency initiatives. Sen. Patrick Leahy, D-Vt., the Judiciary Committee’s ranking member, reminded the committee to maintain a focus on providing more affordable, high-quality care to consumers rather than giving physicians more market power to combat the insurance industry’s increased market share. “If the insurance industry is consolidating to the point where insurance companies can exercise market power, the government’s role is to address that concentration--not add to the problem by creating market power on the other side, leaving consumers out of the equation,” said Leahy. Read the testimonies.
