Why Health Insurers Can, But Won’t, Break Up Medical Monopolies

Robert Pearl, M.D.

Virtual monopolies exist in almost every healthcare sector: from hospitals and health systems to drug companies and private-equity-staked medical practices. With so much consolidation of power and influence, U.S. healthcare has become a conglomerate of monopolies; the subject of this continuing series.

If there’s one big lesson to take from this series so far—something that unites the many monopolies that make up American healthcare—it’s this: As monopolies expand their power and influence in healthcare, they grow complacent. And when that happens, innovation dies.

Ultimately, Americans pay the price with their wallets and their health.

One group, more than any other, wields enough might to stand up to monopolistic hospitals, drug companies and private-equity firms—and could drive industrywide improvements in quality, cost and access.
Doing business with the big five

That mighty sector is the health insurance industry. Of the 300 million insured Americans, more than half (169 million) are …

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