The Medical Association of Georgia (MAG) believes the pending Aetna/Humana and Anthem/Cigna mergers would have disastrous results for patients and physicians in this state.
The new companies would control nearly 90 percent of the individual health insurance market in Georgia – the kind of monopoly that undermines our free market system. What’s more, they would hold dominant positions in the small-group, Medicare and large-group markets.
We have heard assurances that efficiencies achieved by these marriages would lead to lower premiums, but we know better, based on what has transpired with deductibles and co-pays in recent years.
No, the truth is that these deals would result in higher prices and fewer choices. The Journal of the Business School Alliance for Health Management underscored this point when it highlighted a study of a merger between two health insurance companies in Nevada. The merger led to an average increase of 14 percent in premiums in that state.
With little competition, Aetna/Humana and Anthem/Cigna could control costs by further reducing the size of their already limited health care networks and restricting a patient’s access to the doctors and specialists the patient has come to know and rely on.
It is worth noting that today’s physicians have very little leverage when it comes to negotiating the terms of their contracts with these giant conglomerates. The mega-companies subject physicians to take-it-or-leave-it agreements. Meanwhile, the companies sell policies based on the aforementioned increasingly narrow networks to unsuspecting patients who must bear additional out-of-network costs.
The sad reality is that health insurance companies now direct almost every aspect of patient care. And because physicians would be forced to accept less pay for the care they provide, the mergers would exacerbate the physician shortage and undermine the economic viability of Georgia’s health care system. This would be especially true in rural areas, where hospitals and medical practices are struggling to keep their doors open.
Based on my first-hand experience, I know that a lot of physicians see these mergers as a very real threat to the long-term viability of their practices.
With this in mind, MAG is calling on the U.S. Department of Justice to assess these mergers for antitrust violations in a full and comprehensive way.
The Georgia Department of Insurance, meanwhile, has noted that the Aetna/Humana merger may violate Georgia’s competitive standard in the individual, small group, and Medicare Title XVIII markets – as well as substantially reducing competition in the large group market.
As a physician who has cared for patients in this state for more than 25 years, I am more than a little concerned. So I am encouraging my fellow Georgians to send an email to firstname.lastname@example.org to urge Georgia’s insurance department to oppose the Aetna/Humana and Anthem/Cigna mergers.
If these deals are allowed to go through, we will all lose. This is a risk that we simply cannot afford to take.
Dr. Harvey is the president of the Medical Association of Georgia, which represents more than 7,800 physicians in every specialty and practice setting in the state.