The Republican 10 Point Plan for Health Care


Posted by AzBlueMeanie:


One of my favorite economics bloggers, Jon Perr at, has a detailed explanation of The Republican 10 Point Plan for Health Care;

After Rep. Roy Blunt, leader of the supposed House GOP Health Care Solutions Group, suggested Thursday that Republicans won't offer a health care plan of their own, Minority Leader John Boehner insisted one was still in the works.

Of course, the Republican plan as in 1993 is to stop health care reform at all costs to prevent an enduring Democratic majority. Bill Kristol, who told Republicans 16 years ago that there was "no crisis" justifying health care reform then, now simply calls on his party to "kill it." With spinmeisters Frank Luntz and Alex Castellanos supplying the talking points that a supposed "government takeover of health care" is "too much, too fast, too soon," obstructionists like Oklahoma Senator James Inhofe boasted his party would "stall" President Obama's health care initiative to ensure a "huge gain" in the 2010 election. In a nutshell, the GOP is proposing to extend the status quo for a nation gripped by a collapsing health care system.

Here, then, is the Republican 10-Point Plan for Health Care:

  1. 50 Million Uninsured in America
  2. Another 25 Million Underinsured
  3. Employer-Based Coverage Plummets Below 60%
  4. Employer Health Costs to Jump by 9% in 2010
  5. One in Five Americans Forced to Postpone Care
  6. 62% of U.S. Bankruptcies Involve Medical Bills
  7. Current Health Care Costs Already Fueling Job Losses
  8. 94% of Health Insurance Markets in U.S Now "Highly Concentrated"
  9. Dramatic Decline in Emergency Room Capacity
  10. Perpetuating Red State Health Care Failure

For the details and data behind each, continue reading.

I want to focus on No. 8 on the list. This topic has received almost no attention from the corporate media villagers and Beltway bloviators. For all the talk about wanting to "preserve" competition among private health insurers in an allegedly competitive marketplace, the harsh reality is that a small number of health insurers have highly concentrated monopolies in almost every state. A 2006 study by the American Medical Association confirms health monopoly fears:

Data from the American Medical Association shows that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.

The study also shows that in 166 of 294 metropolitan areas, or 56%, a single insurer controls more than half the business in health maintenance organization (HMO) and preferred provider networks (PPO) underwriting.

"This problem is widespread across the country and it needs to be looked at," said Dr. Jim Rohack, an AMA trustee and physician in Temple, Texas. "The choices that patients have now are more difficult."

The AMA study cited a Justice Department benchmark in citing antitrust concerns, the Herfindahl-Hirschman Index, or HHI. A score above 1,000 shows "moderate" concentration. Those scoring above 1,800 yield a "high" concentration.

Figures show that 95% of the 294 HMO/PPO metropolitan markets studied were above 1,800. Raise that HHI bar even higher to 3,000 and yet more than half, or 67%, rise above it.

The AMA study is the latest piece of evidence — and most comprehensive to date — showing the market power of a few companies, and a large number of regional non-profit Blue Cross operations, is formidable and growing. And it comes at a time when premiums continue to grow at near double-digit rates.

Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they're also the biggest purchasers of health care and can dictate prices and coverage terms.

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The AMA says there have been more than 400 mergers among health-care insurers in the past decade. As they've consolidated and presumably eliminated duplicative functions, they're not passing the savings in personnel and administrative costs on to consumers. Rate increases, though slowing, are higher than ever and growing at a near double-digit pace.

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The AMA says it has taken up this antitrust issue with the [Bush] U.S. Department of Justice but says it has run into roadblocks with regulators. AMA officials say regulators seem uninterested, even though government officials are more than willing to target doctors' groups and hospitals on antitrust matters.

Justice Department officials did not respond to requests for comment.

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The AMA has studied the issue of growing health insurer monopolies for several years, and has a vested interest in the subject. It's trying to protect its doctors, who are concerned about declining reimbursements from carriers.

The private insurance companies for whom Republicans and conservadems are so concerned about protecting their market share from a competitive "public option" are in reality insurance monopolies engaged in anticompetitive practices for which the U.S. Department of Justice, under its own guidelines, should be investigating for possible anti-trust prosecutions.

Instead of cutting deals with these insurance monopolies, Congress should be enacting tougher anti-trust laws and the Obama Justice Department should be engaged in a new era of trust busting. "Bully!" as Teddy Roosevelt would say.

For all of you who oppose a non-profit single-payer public health care system, the alternative which already exists and will grow more powerful is a for-profit insurance monopoly/oligopoly/monopsony to which you will be completely at its mercy. No one should be endentured to an insurance giant, subsidized by your own tax dollars no less.

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AZ BlueMeanie
The Blue Meanie is an Arizona citizen who wishes, for professional reasons, to remain anonymous when blogging about politics. Armed with a deep knowledge of the law, politics and public policy, as well as pen filled with all the colors stolen from Pepperland, the Blue Meanie’s mission is to pursue and prosecute the hypocrites, liars, and fools of politics and the media – which, in practical terms, is nearly all of them. Don’t even try to unmask him or he’ll seal you in a music-proof bubble and rendition you to Pepperland for a good face-stomping. Read blog posts by the infamous and prolific AZ Blue Meanie here.


  1. Ironically, the one thing that Luntz may not be able to spin is the thing that I most fear given the state of the U.S. health care system:

    the likelihood of a major swine flu outbreak next year, which according to last week’s papers could sicken as much as half the population of the U.S., send millions to the hospital and kill hundreds of thousands.

    I hope though that that does not happening. Gambling with keeping that many people uninsured in the face of global pandemic of unknown severity over the next couple of years is a little like not following through wtih the 9/11 commission’s recommendations to inspect all the shipping containers for chemical, biological or nuclear weapons (oh, wait– the G.O.P. never did follow up on that), or expecting you could conquer Iraq in a few weeks and be home for Christmas (oh, wait– they did do that,) or maybe the equivalent of rebuilding the New Orleans flood levees only to where they were on August 29, 2005 and gambling that there won’t be another major hurricane there (oh, wait– they did that too, didn’t they.)

    Let us PRAY that the swine flu turns out to be not so bad.