In the health insurance business, size matters.
Bigger companies can more easily spread risk and overhead costs and exact steeper discounts from doctors and hospitals.
But the giant companies that dominate Florida's health insurance market are stifling competition and escalating premiums, said a report issued Wednesday by a consortium of national and Florida consumer groups.
"A few private health insurance companies have built a near-monopoly in the Florida market, burdening families and businesses," said the report by Health Care for America Now. The report said health insurance premiums in Florida rose 3.6 times faster than wages from 2000 to 2007.
Two companies, Blue Cross and Blue Shield of Florida and Aetna Inc., control 45 percent of the health insurance industry in the state, the report said.
In certain metro areas, the industry is even more concentrated. In Palm Beach County, for instance, Blue Cross and United Healthcare control 50 percent of the private health insurance business. In St. Lucie County, Blue Cross and Humana Inc. control 81 percent of the market.
United Healthcare spokesman Roger Rollman blasted the report.
"The idea that UnitedHealthcare market share is driving premium costs is nonsense."
He said the growth in premiums is mostly driven by overall health costs.
As for strangling competition, Florida has more than 45 companies writing health insurance coverage, according to the state Office of Insurance Regulation.
Even the consumer groups' report ranked Florida 43rd nationally in terms of health insurance market concentration. Hawaii was first.
The basic conclusions reached by Health Care for America Now, though, have the support of Sean Shaw, the state's insurance consumer advocate, who says more choice in Florida is needed to drive down costs.
"The lack of competition among health insurers is a huge problem," Shaw said.
In addition, the report's conclusions are supported by American Federation of State County and Municipal Employees and the Florida Public Interest Research Group.
Health Care for America Now said the report's findings illustrate the need for Congress to establish a public health plan option to compete with private insurers. Such a plan is expected to be part of President Obama's health reform proposals, which are aimed at covering the country's 46 million uninsured and lowering overall health costs. "A public service plan would add a healthy dose of competition," said Shaw.
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