"I am not an advocate for frequent changes in laws and constitutions. But laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain ever under the regimen of their barbarous ancestors." - Thomas Jefferson (appears in the Jefferson Memorial)

Health insurance monopoly, NW

The idea of a competitive health insurance marketplace sounds not too bad, but it’s a long way from the reality.

A report from Health Care for America Now (dating from May 2009 but useful again in the current debate) has broken out the concentration of health insurers by state. How did the Northwest states rank?

Idaho had the 16th most concentrated – least competitive, most monopolized – health insurance markets among the 50 states. Blue Cross of Idaho (46% of the market) and Regence Blue Shield (29%) together take up 75% of the Idaho market.

The report: “For family health coverage in Idaho during that time [2000-07], the average annual combined premium for employers and employees rose from $5,160 to $11,432. . . . During that time, health insurance premiums for Idaho working families rose four times faster than median earnings.”

Washington was somewhat better off, at 34th among the 50. There, Premera Blue Cross had 38% of the market and Regence Blue Shield 23%, for a total between the two of 61%.

Family coverage cost increases in Washington? On average, from $6,496 to $12,120, or 5.3 times faster than median earnings.

Of the three states, Oregon was actually best off, ranking 40th. Providence Health & Services had 25% of the market, and Regence Blue Cross Blue Shield 23%, for a total of 48% – not quite half.

Family coverage in Oregon rose in those years from $6,654 to $12,321, about 4.7 times faster than median earnings.

Of course, those skyrocketing figures are somewhat out of date; they’re obviously larger by now.

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