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house Bill H.R. 372

Should Federal Antitrust Law Apply to Health Insurance?

Argument in favor

Health insurance companies shouldn’t be exempt from antitrust laws that would otherwise punish them for colluding and price fixing -- actions that hurt consumers and enrich insurers.

Andrew's Opinion
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03/20/2017
As long as we are going to allow health insurance providers to profit from the American people and their well-being, they should be subject to rigid anti-trust regulations. It is noteworthy, however, that such regulation would be unnecessary with universal healthcare such as exists in all other developed nations.
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Caitlin's Opinion
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03/21/2017
The American healthcare system is a profitable industry. It has become an increasingly lucrative business at the price of bankrupting the working class. There are many politicians who take contributions from insurance and pharmaceutical corporations so that their interest in making money off the American people is itself ensured. This is clearly not right. Congress was unable to pass a bill earlier this year that would allow American citizens the ability to buy prescription drugs from Canada at a fraction of the price they pay in the United States. The fact that this bill came into existence and was then abruptly voted down is a symptom of a larger sickness within the medical industry and American politics caused primarily by greed. There is NO EXCUSE why the United States is ranked below the rest of the developed world in healthcare quality while ranking the highest in costs. So while we throw more money at the war machine for the next (4) years, Americans will still not be granted a single-payer Medicare-for-all system and we will pay more for medicines, routine check-ups, emergencies and scheduled procedures than any other democracy in this world. Women in this country still have to fight for paid maternity leave while insurance CEO's make more money in one lifetime than they can possibly spend. People are dying of cancer because only the top 1% can afford $10k a month in chemo medicines. These are crimes against humanity caused by the ability of insurance and pharmaceutical companies to set whatever prices they think people are willing to pay and the American people are suffering because of it. Please stop this madness.
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Anne's Opinion
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03/20/2017
I recently retired from an executive position in the Property and Casualty insurance industry, so I know the effect of antitrust laws on insurance pricing and underwriting standards. Without antitrust guidelines, insurers collude on pricing and underwriting - a practice I witnessed on several occasions prior to antitrust laws applying to the P&C side of the insurance industry. There is no reason antitrust laws should exempt health insurance carriers. If health insurance carriers could not share their pricing and underwriting strategies, I am certain we would see REAL competitive pricing and products. It is a travesty that these laws do not already apply to health insurers.
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Argument opposed

By not subjecting them to antitrust law, the status quo enables health insurance companies to provide better service to consumers. It’d be foolish to end the exemption.

TuckerWantsLiberty's Opinion
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03/20/2017
Rather than artificially increasing competition through interventions like this, how about we solve the problem with MORE freedom and remove some of the government's artificially-imposed barriers to entry and increase competition that way? The only monopoly that hurts consumers is a government-enforced one. A monopoly in a free market arises and persists because it provides an unmatchable value for consumers. This must be so because as soon as an opportunity to provide better value arose, a new competitor would enter the market. If there's an opportunity to provide better value (i.e., better service and/or better price), then a new market entrant could steal the whole market by better serving consumers. The only way to become and remain the only player is to provide the best quality service at the lowest possible price. Harmful monopolies are the ones where the government creates arbitrary barriers to entry so that the threat of new market entrants is minimized. THOSE are the ones where you see price gouging because they know that government laws and regulations are preventing newcomers from entering the market and undercutting them. Think of the EpiPen monopoly that was protected by the FDA. Think of health insurance not being able to sell across state lines and how that ties the hands of little guys that are trying to compete. We don't need the government to intervene here. We need them to get out of the way and stop making things worse.
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Joseph's Opinion
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03/22/2017
How do I change my vote?? I just wanted to see who voted nay!!
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Reesa 's Opinion
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03/21/2017
Does not help the people that need it the most! Seniors, sick and poor. Do not vote for this farce.
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    As long as we are going to allow health insurance providers to profit from the American people and their well-being, they should be subject to rigid anti-trust regulations. It is noteworthy, however, that such regulation would be unnecessary with universal healthcare such as exists in all other developed nations.
    Like (589)
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    Rather than artificially increasing competition through interventions like this, how about we solve the problem with MORE freedom and remove some of the government's artificially-imposed barriers to entry and increase competition that way? The only monopoly that hurts consumers is a government-enforced one. A monopoly in a free market arises and persists because it provides an unmatchable value for consumers. This must be so because as soon as an opportunity to provide better value arose, a new competitor would enter the market. If there's an opportunity to provide better value (i.e., better service and/or better price), then a new market entrant could steal the whole market by better serving consumers. The only way to become and remain the only player is to provide the best quality service at the lowest possible price. Harmful monopolies are the ones where the government creates arbitrary barriers to entry so that the threat of new market entrants is minimized. THOSE are the ones where you see price gouging because they know that government laws and regulations are preventing newcomers from entering the market and undercutting them. Think of the EpiPen monopoly that was protected by the FDA. Think of health insurance not being able to sell across state lines and how that ties the hands of little guys that are trying to compete. We don't need the government to intervene here. We need them to get out of the way and stop making things worse.
    Like (18)
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    The American healthcare system is a profitable industry. It has become an increasingly lucrative business at the price of bankrupting the working class. There are many politicians who take contributions from insurance and pharmaceutical corporations so that their interest in making money off the American people is itself ensured. This is clearly not right. Congress was unable to pass a bill earlier this year that would allow American citizens the ability to buy prescription drugs from Canada at a fraction of the price they pay in the United States. The fact that this bill came into existence and was then abruptly voted down is a symptom of a larger sickness within the medical industry and American politics caused primarily by greed. There is NO EXCUSE why the United States is ranked below the rest of the developed world in healthcare quality while ranking the highest in costs. So while we throw more money at the war machine for the next (4) years, Americans will still not be granted a single-payer Medicare-for-all system and we will pay more for medicines, routine check-ups, emergencies and scheduled procedures than any other democracy in this world. Women in this country still have to fight for paid maternity leave while insurance CEO's make more money in one lifetime than they can possibly spend. People are dying of cancer because only the top 1% can afford $10k a month in chemo medicines. These are crimes against humanity caused by the ability of insurance and pharmaceutical companies to set whatever prices they think people are willing to pay and the American people are suffering because of it. Please stop this madness.
    Like (346)
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    I recently retired from an executive position in the Property and Casualty insurance industry, so I know the effect of antitrust laws on insurance pricing and underwriting standards. Without antitrust guidelines, insurers collude on pricing and underwriting - a practice I witnessed on several occasions prior to antitrust laws applying to the P&C side of the insurance industry. There is no reason antitrust laws should exempt health insurance carriers. If health insurance carriers could not share their pricing and underwriting strategies, I am certain we would see REAL competitive pricing and products. It is a travesty that these laws do not already apply to health insurers.
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    Health insurance companies DO NOT provide health care. Doctors and hospitals provide health care - let's be clear about at least that. Health insurance companies are a big part of the problem with regard to elevating the cost of health care in order to maximize THEIR profit margin. Like all businesses they must be subject to antitrust regulations. If there was anything wrong with the ACA, it was its pandering to health insurance companies, which president Obama had to do to get it passed the republiCON corporate welfare ideology.
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    Having worked for a 'non-profit' blues plan health insurance company for 13 years, regulation is warranted and necessary to prevent further fleecing of Americans in their most vulnerable moments -health crises. As another constituent commented, "As long as we are going to allow health insurance providers to profit from the American people and their well-being, they should be subject to rigid anti-trust regulations. It is noteworthy, however, that such regulation would be unnecessary with universal healthcare such as exists in all other developed nations."
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    Yes absolutely
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    Antitrust laws were originally created because we know monopolies harm consumers. Healthcare is a basic human right and an unregulated insurance market harms consumers, just as any unregulated market does (think about the financial crisis in 2008). Protect consumers, regulate healthcare.
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    I had one insurance carrier to choose from this year, working with them has me to the point of not even wanting to use my insurance, and a wait to see a doctor is absurd. Along with broadband, insurance is one of the largest monopolies in this country and it's time we treat it as such.
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    I vote YEA, and thank you, Rep. Gosar and cosponsors, for caring about We the People/consumers! Cosponsors: Rep. Brat, Dave [R-VA-7]* Rep. Brooks, Mo [R-AL-5]* Rep. DesJarlais, Scott [R-TN-4]* Rep. Duncan, John J., Jr. [R-TN-2]* Rep. Gohmert, Louie [R-TX-1]* Rep. Jones, Walter B., Jr. [R-NC-3]* Rep. King, Steve [R-IA-4]* Rep. Roe, David P. [R-TN-1]* Rep. Scott, Austin [R-GA-8]* Rep. Yoho, Ted S. [R-FL-3]* Rep. Ferguson, A. Drew, IV [R-GA-3]* Rep. Wittman, Robert J. [R-VA-1]* Rep. Babin, Brian [R-TX-36]* Rep. Smith, Lamar [R-TX-21]* Rep. Biggs, Andy [R-AZ-5] Rep. Lamborn, Doug [R-CO-5] Rep. Sanford, Mark [R-SC-1] Rep. Garrett, Thomas A., Jr. [R-VA-5] Rep. Labrador, Raul R. [R-ID-1] Rep. Tipton, Scott R. [R-CO-3] "One aspect of Republican proposals for healthcare reform in the United States is allowing INTERSTATE COMPETITION [emphasis mine] for health insurance, potentially requiring modification of the McCarran–Ferguson Act. In February 2010, the House of Representatives voted 406-19 to repeal the McCarran–Ferguson Act with regard to health insurance." http://en.wikipedia.org/wiki/McCarran%E2%80%93Ferguson_Act Repeal McCarran-Ferguson - Before it's too late By David A. Balto, former policy director, FTC April 08, 2013 - 07:40 PM EDT Let’s put this into perspective. There are extraordinarily few antitrust exemptions and for good reason. Antitrust exemptions mean that competitors do not have to compete. They can live the cozy life where they work cooperatively to have a stable and profitable market. And consumers pay the price in higher prices, less choice and less innovation. The McCarran-Ferguson exemption was passed in 1945 to protect small insurance companies incorporating at that time who had a great need for data from existing insurers in order to set premiums effectively. Because such information sharing was illegal under the antitrust standards of the era, Congress provided an antitrust free pass. It doesn’t take an historian or an antitrust scholar to recognize that market conditions are vastly different today than they were 68 years ago. Almost all health insurance markets are highly concentrated and many are dominated by one or two insurers. Congress hoped that state regulation would suffice, but the states bring few if any meaningful cases against health insurers. In addition, there is no need for an exemption since the practices that led to the Act are now considered legal under standards of antitrust law. If there was one thing clear from the Congressional debate over health care, it is that health insurance markets are unhealthy. Over the past few decades, profits have increased dramatically, and the market has become one of the least transparent and most anticompetitive markets in the nation; indeed, few markets are as concentrated, opaque and complex, and subject to rampant anticompetitive and deceptive conduct. There is simply an immense need for antitrust and consumer protection enforcement to reign in the constant abuses of the industry. Unfortunately for consumers, McCarran-Ferguson often creates obstacles to effective enforcement. The Federal Trade Commission has a stellar record for policing consumer protection violations and preventing unfair trade practices in almost every market, but McCarran appears to rob it of health insurance jurisdiction. And McCarran may dampen the ability of private parties to bring antitrust and consumer protection actions. Because oversight authority of the industry has essentially been left to the states, it is subject to virtually no consumer protection enforcement, except in the few states like California, New York, and Florida that have very active insurance regulators and antitrust enforcers. A study by the Center for American Progress found that the vast majority of enforcement actions against health insurers were taken by only five states. In far too many states, a few insurers dominate the market, and authorities lack the resources or expertise to conduct substantive competition or consumer protection oversight; tellingly, in four states, the insurance commissioner is also the fire marshal. Repealing McCarran-Ferguson would return oversight to the federal government where it belongs, and allow for robust consumer protection enforcement that is sorely lacking. Four different bills to repeal the exemption have already been introduced this Congress: H.R. 99, 344, 743, and 911, by Representatives Conyers, Lynch, DeFazio and Slaughter, and Gosar, respectively. The need to act on these bills is urgent. Federal antitrust and consumer protection enforcement is essential for the health insurance exchanges to work effectively. Antitrust enforcement is critical to prevent practices by insurers that will dampen competition, allocate markets, reduce options, or attempt to raise prices. (This is no idle threat in these highly concentrated markets in which health insurers traditionally act in lock step). Federal consumer protection enforcement is necessary to make sure there is adequate transparency and information. Yet the McCarran exemption appears to preempt our federal consumer protection enforcer – the Federal Trade Commission – from bringing antitrust or consumer protection cases against health insurers. And it may prevent policing of the anticompetitive conduct that may rob consumers of the benefits of the new exchanges. This is no time to have the federal government attempt to police this critical market with one hand tied behind its back. Congress should repeal the McCarran-Ferguson Act. Balto is an antitrust attorney, consumer advocate, and former Federal Trade Commission policy director. He is a program fellow in the Health Policy Program at the New America Foundation and a former senior fellow at the Center for American Progress. The views expressed herein represent only those of Mr. Balto and not of the New America Foundation. http://thehill.com/blogs/congress-blog/economy-a-budget/292405-repeal-mccarran-ferguson-before-its-too-late
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    There can be many reasons to support this bill. Since both left and right always complain about transparency in Civil Government, I will support open transparency on laws governing Health Care Insurance corporations. I also support transparency in the House, Congress and the White House. May I also add that when partial facts are used to support an individual point of view, it's not true transparency. I remember the adage on a glass of water, whether it is a glass half full or half empty? If the glass was never full, then it's half full. Glass is half full is true. Glass is half empty is true. But transparency that the glass was never filled to full sets the full facts. Transparency is important too know in making this decision. An opaque glass leaves you only guessing.
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    Every industry should be subject to these laws.
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    Increased competition would help lower prices and better the quality of care. Economics 101.
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    Absolutely yes. Monopolies in general are harmful to consumers, but a monopoly by a heath care provider is especially dangerous. Why have they been exempted in the first place?
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    How do I change my vote?? I just wanted to see who voted nay!!
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    How is this debatable?
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    It is crucial that we wrestle the health insurance behemoth to the ground. They hold us hostage for outrageous and unaccountable costs. How is it possible that prices for the same service can be radically different from provider to provider. There is no accountability. Please keep up this important work!
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    Well thank goodness you all did something right for once! Of course we wouldn't need this legislation if we had single payor Medicare for all. Because no part of covering healthcare should be for the profit of an insurance company.
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    To do otherwise permits unfair and harmful consumer practices against the most vulnerable members of our society.
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    I cannot think of a single good reason this should not be enacted. Applying antitrust laws to insurance companies that are raking in huge profits can only provide a needed level of protection for consumers. Anyone who has ever dealt with an insurance company knows their tendencies toward profit driven unscrupulous, screw the consumer behavior. The more oversight there is the less vulnerable I will feel. Of course, as Countable member Andrew mentioned, if we would just do the sensible thing and move to a single payer system none of this would be necessary.
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