It's about time: Insurers facing antitrust scrutiny

Federal antitrust enforcement has been too lax against health plans that like to use their marketplace clout to bully doctors. Now that may be changing.

Editorial. Oct. 14, 2002.

As the health care marketplace has evolved into a competition of physician Davids against health plan Goliaths, federal antitrust enforcement so far has unfortunately favored the big guys.

Consider the circumstances.

Despite major consolidation among insurers in the past several years, federal officials continued to focus antitrust efforts on physicians. No one is arguing that doctors should be allowed to get away with anti-competitive behavior, but the government's intense policing is out of whack with physicians' economic strength in the marketplace.

Even as many health plans merged into insurance giants, federal enforcers took not a single action against a third-party payer, by the AMA's estimation.

That imbalance must change. The American Medical Association is calling on the government to make a fundamental shift in how it deploys its health care antitrust resources. In other words: It's time to get tough on the Goliaths.

In recent weeks, the federal government has begun to show signs that it will turn its attention to insurers. The Justice Dept. antitrust division recently announced that it would make close scrutiny of insurer mergers a priority. It also will begin evaluating unilateral or coordinated insurer conduct.

This is an encouraging first step and should be followed by real action.

Already the power wielded by several health insurance juggernauts has skewed the health care marketplace, leaving consumers and doctors to feel the impact.

More than 50% of privately insured people are covered by one of the 10 largest health plans. An AMA study last year found that in many areas of the country, a few large health plans have market dominance. [...]