There's no clash of the Titans in the small-business health insurance market right now.
While
some consider BCBS's aggressive acquisition of market share as proof of
savvy business practices, others allege that these practices violate
antitrust laws. |
According
to a recent report by the United States General Accounting Office
(GAO), 25 of the 37 states identify a Blue Cross and Blue Shield (BCBS)
plan as the largest health insurer in their small-business market. In
all but one of the remaining 12 states, a BCBS plan is among the top 5.
In three states — Alabama, North Dakota, and Washington — BCBS plans
have cornered more than 75 percent of the small-business health insurance market.
Whether
the domination of the nation's small-business market by BCBS is cause
for celebration or alarm depends on who's telling the story.
Clearly,
BCBS is thrilled. "The GAO report demonstrates that BCBS plans are one
of the most popular choices among small employers selecting benefits
for their businesses," says John Parker, a spokesman for the Blue Cross
and Blue Shield Association (BCBSA), which is comprised of 43
independent BCBS companies nationwide.
Others are not so
enthusiastic. "The GAO report confirms that the small-employer health
insurance market is burdened with a lack of free market competition,"
says Joseph Rossman, vice president of insurance for the Associated
Builders and Contractors, a national organization that represents more
than 23,000 construction and construction-related firms.
Some
consider BCBS's aggressive acquisition of market share proof of savvy
business practices. Others allege these practices violate anti-trust
laws by using that power to force hospitals and doctors to accept
artificially low payments for their services and to charge consumers
and employers excessive premiums.
One
Pennsylvania hospital says it has had enough. The Chester County
Hospital in West Chester, Pennsylvania, filed a lawsuit against
Independence Blue Cross (IBC) and several of its subsidiaries, accusing
the region's largest health insurer of anti-competitive business
practices. According to the lawsuit, IBC's plans cover approximately 75
percent of southeastern Pennsylvania's 3.7 million residents.
Chester
County Hospital President H.L. Perry Pepper says his organization has
no other choice but to sue IBC. "We believe IBC has amassed an
exceedingly high market share and then taken advantage of that power by
coercing us, on a 'take it or leave it' basis, to accept rates which
are depleting the hospital's charitable resources," he says.
According to the lawsuit, IBC's plans cover
approximately
75 percent of southeastern Pennsylvania's
3.7 million residents. |
According
to the lawsuit, Chester County Hospital lost $8.5 million providing
services to IBC plan members in fiscal 2001. The insurer paid the
hospital about $34 million that year.
IBC officials say
they are "disappointed" the hospital filed the lawsuit. IBC
points out the suit was filed in the early stages of a five-year
contract with IBC. IBC suggests the hospital filed the suit in an
attempt to "sweeten" the terms of that contract.
IBC
also claims the lawsuit is nothing but a "smoke screen that will
distract Chester County residents from asking important questions about
how their community hospital is being run."
Blue Cross and Blue Shield plans welcome competition, according to the BCBSA.
BCBSA
spokesman John Parker points out the GAO study shows the median number
of health insurers offering coverage in the small business market is
actually 28 per state. Parker says that’s proof there’s plenty of
competition.
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