Oligopoly in Terms of the Us Health Insurance Industry

A common saying is Support the small businesses. One may have been confused with this saying, then this information will help one understand. It may not be directly stating this in the quote, but this is explaining that monopolies shouldn’t own everything. Monopolies are only beneficial for the company, or companies, that own everything and it will hurt everyone else. This is why monopolies were made illegal in America, which is idealistic for citizens. Small businesses can be hurt by monopolies and little companies are terrific for the citizens. Antitrust Laws are needed to keep monopolies from hurting small businesses. A person may not understand why Monopolies are bad, but the provided research will further educate one in this very controversial

There is a move from a noncompetitive insurance environment to a competitive one because the competition was not by hospitals to provide the best and cheapest care, but rather among the insurers to get the healthiest patients. Consumer driven plans are central to the process because they are ideal for risk selecting the young and fit who have been driven to new plans. Healthy people could watch their account balances grow which leaves the truly sick behind in traditional plans. This particular type of competition is being used to attract the healthy and in turn lead to price increases because insurers have little incentive to control the prices medical providers are charged. It is the responsibility of the patients to worry about the cost and the patient does not have the same power as the insurance competitors do. According to a key South African regulator, Alex van den Heever of the Council for Medical Schemes, “Competition based on the shifting of risk

Despite the large number of funds, the market is an oligopoly, this is due to relatively concentrated top five funds accounting for 83% market share at Jun-13; this is shown in the graph below (JP Morgan, 2015). These five top funds include Medibank, BUPA, HCF, HBF and NIB. While there is a long-tail of smaller players, acquisition activity over the past five years has been relatively limited with only a handful of deals as shown below in the table below. This reflects the fact that smaller restricted and not-for-profit player have not been squeezed out due to being given the access to scale efficiencies through third-party collective bargaining groups (white label other insurance companies policies), technology as well as benefits from risk equalization. Large players such as BUPA and Medibank sought acquisitions (refer to table) and/or vertical integration to get scale, efficiencies and brand power. The large funds in addition are investing heavily in wellness benefits to enhance their brand proposition, and are shunning the online aggregators. Some of the medium sized insurers such as NHF, Australian Unity, and HCF are seeking to grow outside their home states, to maximize their potential

Universities stemmed some of the biggest medical advances in the health care industry amongst the world. The educational platform for the United States spells long term success for health care, by growing the next generation of top health care providers. In comparison Germany and Canada also are represented amongst the top 50 medical schools in the world, but lack any representation of the top 10 prestige rankings. On top of that, both other countries lack volume and opportunity to receive a valued medical education when compared to the United States.

Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.

The Affordable Care Act was created to assure all Americans have access to affordable insurance, but as stated by Sir Isaac Newton for every action there’s an equal and opposite reaction. As more and more people become insured in this country, the for-profit insurance companies are reaping the benefits from the legislation of the Affordable Care Act.

Regulations that prevent insurance companies from participating in interstate commerce have caused competition to grow stagnant in the United States. This lack of competition has allowed the adoption of wasteful procedures by healthcare providers, which in turn passes the increased expenses back to the insurance companies. Therein, insurance costs increase, crippling consumer’s cash flow and quality of life. While healthcare costs continue to rise, people must scrutinize the current healthcare system.

The health insurance market in the United States has been anything but competitive since the dawn of it 's existence. In many states, a single health insurance provider dominates the market, with virtually no competition (Holahan and Blumberg). In the past, before 2010, there has been no “marketplace” to compare prices for health insurance, which has contributed to ignorance in terms of finding competitive, lower prices for health insurance. Essentially, health insurance providers have been “price makers” rather than “price takers” because the demand for health insurance is relatively inelastic (as people will always get sick or get

Unfortunately, although antitrust agencies are paying attention to recent court actions against mergers, the FTC investigates only 1-2% of consolidations (McCanne, 2014). It is also important to remember than public payers such as Medicare and Medicaid set prices to physicians and hospitals with no room for negotiating and conversely private insurers may use their market-share leverage to negotiate reimbursements. Integrative care in the form of hospital consolidation has been shown to reduce costs by 10-20% but this cost has not been shown to produce a cost savings to private insurers (Cutler & Morton, 2014).

It's no secret that Health Maintenance Organizations, known as HMO's, have made healthcare affordable for many Americans, but at what risks? Most employers offer some type of health care plan that is an HMO. Let's face it, given the choice among insurance coverage through your employer, in which he pays half the costs, or acquiring private insurance coverage outside your employer, most Americans choose to go with employer-provided HMO's. Why then, has there been so much controversy with HMO's?

The demand for health care service is increasing steeply as there are more people starts to recognize the benefit if they enroll to one of the health care. From consumer point of view, they are always looking for the best quality of the product and service with the least amount of money. Today, the demand for premium healthcare services have increased even though the price is relatively high. If a consumer were offered a better service than the one she has paid, the consumer will switch plans with a better benefit for them. The competition for healthcare service between companies is called perfect competition. Perfect competition offer consumer with identical product with different brand and is hard for them to

The health sector is among the most important sectors in the United States economy. The government has enacted certain laws that affect the corporation’s activities and the insurance industry in general. The regulation affects competition among the health insurance companies, and the insurance industry in general.

Another group often blocked is complementary or alternative health care practitioners. These restrictions and the insurance industry unwillingness to pay for these services, gives the physicians an almost monopolist control over health care. Providers must be able to enter the market for competition to work and there must be many providers vying for the patient. To get the most out of health insurance plans Consolidation of hospitals and multispecialty group practices increases the negotiating leverage of the group but in certain areas of the US a single large medical system has become the sole provider of major health service thereby restricting competition (Shi & Singh, 2008). This consolidation while giving the hospitals and group practice leverage when negotiating prices of supplies and services tends to increase the price of health care to the patient because there is no longer any competition (Shi & Singh, 2008). For these reason “competition will remain less effective in most health care markets, because the prerequisite for fully competitive markets are not fully met” (Federal Trade, 2004, p. 20).

There are many different forms of competition among health care organizations. Some of them are the prices of services, different co-pays someone will have to pay out of pocket, lower premiums, they have to be competitive in the quality of the service in which they perform daily. The health care competition is being advertised every day. The competitive nature of business cause them to reach out to the community. The health care industry has to fight for the approval of the community, the government, the insurance companies, the pharmaceutical companies and of course the stake holders as well as future investors.

(a) A majority of areas previously reserved for public sector have been thrown open to private sector to strengthen the forces of competition. In contrast, life and general insurance companies remain state monopolies. The question arises as to why the consumer of insurance services should not be provided a wider choice so that he can get the benefits of competition in terms of a wide range of insurance products, lower price of the insurance covers and better consumer service.