Joseph Paduda's weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.

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Will insurers fight universal coverage?

Perhaps.

But I think not. At least the smarter ones won't.

Health plans/insurers/managed care companies are all suffering from mature market malaise. This dread affliction affects companies toiling in an industry with very low growth, dominated by a few large competitors, wherein these competitors can only grow by taking market share from each other (by slashing price) or by acquiring whatever companies are left to buy.

Unless, the market gets bigger.

While accepted wisdom has it that health plans will fight any significant efforts by Washington DC to expand coverage to all Americans, I disagree. The market in the early nineties was much more fragmented than it is today, there were many more players, and share was more easily captured.

That is most definitely not the landscape we live in today. Not only is the market much more oligopolistic, it is also shrinking every year as premium expenses cause individuals and companies to drop coverage.

Wellpoint, Aetna, United, et al would be delighted to see their potential market expand by 44 million folks. And that's why they would find it tough to fight any expansion of coverage that opened up this huge new market.

Politics is the art of the possible. And when big insurers like something, that 'something' gets a lot more possible.

Comments

WellPoint and Aetna have been growing steadily into the managed Medicaid space. Others, like United and Humana, have been backing away from it. Seems to me WellPoint and Aetna are the ones headed in the right direction on that one since, after all, when coverage of the uninsured comes, it's going to be coverage of folks most like the existing Medicaid population.

Joseph Paduda is the principal of Health Strategy Associates.

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