Domination of Hampton Roads Health Insurance Market by Two Providers Could Hurt Consumers

The domination of the health insurance market in Hampton Roads by two companies is revealed in a report from the American Medical Association, according to the Virginian-Pilot.

The companies in question are WellPoint, the parent company of Anthem Blue Cross and Blue Shield of Virginia (VA), and Optima Health.

The article says WellPoint had a 70 percent share of the preferred provider organizations, while Sentara Healthcre-owned Optima Health had 58 percent of the health maintenance organization market.

Some experts believe the domination of these two companies isn't good for consumers. According to Dr. James Rohack, immediate past president of the American Medical Association, it leads to higher insurance premiums for consumers and lower reimbursements for physicians, the Pilot reports.

Our firm has highlighted many instances in which the health insurance industry fails to look after those who pay premiums.

In serious personal injury and wrongful death cases, we have highlighted cases where the insurance companies have abandoned those people who made regular payments.

A recent example involved a health insurance company who insured a 57-year-old Virginia Beach heart attack victim. The woman had been paying for protection for many years. She recently suffered a disabling heart attack which required extensive hospitalization. Sadly, once her insurance company realized the size of medical bills, they cancelled her insurance policy claiming that she knew that she had the heart condition before she took it out.

We believe issues such as the domination of the healthcare insurance market by large companies, as opposed to medical malpractice claims, are pushing up health care insurance premiums.

In 2009 we said one of the biggest myths perpetuated by advocates of tort reform is the argument that health insurance premiums have increased substantially due to a rise in medical malpractice claims and payouts. This is, in fact, false, especially in Virginia. Another well-rehearsed inaccuracy is the claim courts are inundated with frivolous law suits. A recent Harvard study showed that 97 percent of all medical malpractice claims have merit.

Views also differ on whether there is a "crisis" in medical malpractice insurance industry. According to a recent study released by the nonprofit group Americans for Insurance Reform, there is no crisis and rates of medical malpractice insurance cover have fallen.

DM