Nice to see Obama taking them on like this. I just wish he talked like this more often:

WASHINGTON — President Obama mounted a frontal assault on the insurance industry on Saturday, accusing it of airing “deceptive and dishonest ads” to derail his health care legislation and threatening to strip the industry of its longstanding exemption from federal anti-trust laws.

In unusually harsh terms, Mr. Obama cast insurance companies as obstacles to change interested only in preserving their own “profits and bonuses” and willing to “bend the truth or break it” to stop his drive to remake the nation’s health care system. The president used his weekly radio and Internet address to push back against industry assertions that legislation will drive up premiums.

The transcript is much more blunt:

A new report for the Business Roundtable – a non-partisan group that represents the CEOs of major companies – found that without significant reform, health care costs for these employers and their employees will well more than double again over the next decade. The cost per person for health insurance will rise by almost $18,000. That’s a huge amount of money. That’s going to mean lower salaries and higher unemployment, lower profits and higher rolls of uninsured. It is no exaggeration to say, that unless we act, these costs will devastate the US economy.

This is the unsustainable path we’re on, and it’s the path the insurers want to keep us on. In fact, the insurance industry is rolling out the big guns and breaking open their massive war chest – to marshal their forces for one last fight to save the status quo. They’re filling the airwaves with deceptive and dishonest ads. They’re flooding Capitol Hill with lobbyists and campaign contributions. And they’re funding studies designed to mislead the American people.

Of course, like clockwork, we’ve seen folks on cable television who know better, waving these industry-funded studies in the air. We’ve seen industry insiders – and their apologists – citing these studies as proof of claims that just aren’t true. They’ll claim that premiums will go up under reform; but they know that the non-partisan Congressional Budget Office found that reforms will lower premiums in a new insurance exchange while offering consumer protections that will limit out-of-pocket costs and prevent discrimination based on pre-existing conditions. They’ll claim that you’ll have to pay more out of pocket; but they know that this is based on a study that willfully ignores whole sections of the bill, including tax credits and cost savings that will greatly benefit middle class families. Even the authors of one of these studies have now admitted publicly that the insurance companies actually asked them to do an incomplete job.

John Conyers and some allies on the House Judiciary Committee have come up with a fabulous way to get the insurance industry in line - by threatening to remove their anti-trust exemption.

Many people don't know that the insurance industry, under the McCarran-Ferguson Act of 1945, has a broad anti-trust exemption that facilitates regional monopolies. The Act allows states to regulate the insurance business instead of the federal government, but also allows that, as long as the state regulates the industry, federal anti-trust laws would not apply.

As a result of this exemption, states have seen markets for health insurance where one or two companies predominate. In the state of Maine, Wellpoint controls 71% of the market. In North Dakota, Blue Cross controls 90%. Using the Herfindahl/Hirschman Index, a metric for market concentration, a 2007 study by the AMA found almost every health insurance market in the United States is highly concentrated.

This edition of the study analyzed 313 MSAs. This compares with 292 metropolitan areas in the 2005 study, 84 in the 2003 study, 70 in the 2002 study, and 40 in the 2001 study.

In terms of market concentration (HHI), the study found the following:

In the combined HMO/PPO product market, 96 percent (299) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.
In the HMO product market, 99 percent (309) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.
In the PPO product market, 100 percent (313) of the MSAs are highly concentrated (HHI>1,800), applying the 1997 Merger Guidelines.

Here's the AMA study. Paul Rosenberg has a lot more on this.

The point is that the concentration of the health insurance market among regional monopolies leads to higher costs for consumers, almost by definition. What the legislation by Conyers (D-MI), Hank Johnson (D-GA) and Diana DeGette (D-CO) would do is end that anti-trust exemption for health insurers, allowing for enforcement in all of these highly concentrated markets. The Senate has companion legislation:

“This legislation would specifically prohibit price fixing, bid rigging, and market allocation in the health insurance industry,” said Conyers. “These pernicious practices are detrimental to competition and result in higher prices for consumers. Conduct that is unlawful throughout the country should not be allowed for insurance companies under antitrust exemption. The House Judiciary Committee held extensive hearings on the effects of the insurance industry’s antitrust exemption throughout the 1980s and early 1990s. It became clear then that policyholders and the economy in general would benefit from eliminating this exemption.

“The legislation we introduced today is intended to root out unlawful activity in an industry grown complacent by decades of protection from antitrust oversight. In doing so, we aim to make health insurance more affordable to more Americans. I want to thank my friend Senator Leahy for his leadership on the bill and for working with the House on this joint introduction.”

Many of the actions taken by the insurance industry over the years simply violate federal law. Repealing their anti-trust exemption would force the industry to end their criminal ways or face punishment. As a companion to insurance regulations designed to lower prices for consumers, but perhaps without the kind of enforcement necessary to maintain it, I couldn't think of anything better. And if nothing else, this legislation is a powerful whip to keep the industry in line as they try to extract more perks from the health care bill. Combine this with the multiple investigations into industry practices from Dennis Kucinich, Henry Waxman and others, and you have real pressure on the industry for the first time in a while.

Good for John Conyers.

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(Sen. Joseph C. O'Mahoney 1950 - back when Anti-Trust laws meant something)

I've been reading a lot lately about the recent call-for-boycott of The Whole Foods supermarket chain - how disclosures have been coming to light of predatory practices with reference to killing off small business seen as competition in the marketplace.

I came across a broadcast, part of the American Forum series from January 22, 1950, featuring a debate between Senator Joseph C. O'Mahoney (D-Wyoming) and Carl Beyer, a Public Relations Consultant for the A&P Supermarket chain over a series of court cases regarding A&P and their labor and business practices.

In 1950, A&P was probably the largest single supermarket chain in the U.S. But not only that, they were also one of the larger conglomerates in the food industry, owning several related subsidiary companies, pretty much like large corporations are now.

But in 1950 there were a series of strong Anti-Trust laws in place that prevented corporations from gaining a monopoly in the marketplace. And A&P were at the center of such a controversy, one that went all the way to the Supreme Court.

I lieu of our recent "Companies too big to fail" dilemma, one would imagine our anti-trust laws have been gutted and abandoned in recent years, tossed out in favor of predator-monopolies. The whole change in landscape of our media, our entertainment, our banking have come about as a direct result of tossing Anti-trust out the window.

This lively debate certainly nails some fundamental problems we're facing today.

Ones that need to be taken seriously (for a change) again.