The constitution puts regulation of trade between the states squarely in the laps of congress. If there are only one or two insurers in a state, that is the fault of the federal government. That is something they could change right now and they don't need some thousand page health care reform bill to do it. Part of the reason that insurance costs are so high isn't because the free markets have failed, it is because there are no free markets.

If they truly want competition, then they would go right now, write up a single page bill allowing Americans to buy health insurance across state lines, and then see what that one change alone does to the cost of insurance premiums across the nations. A...

The constitution puts regulation of trade between the states squarely in the laps of congress. If there are only one or two insurers in a state, that is the fault of the federal government. That is something they could change right now and they don't need some thousand page health care reform bill to do it. Part of the reason that insurance costs are so high isn't because the free markets have failed, it is because there are no free markets.

If they truly want competition, then they would go right now, write up a single page bill allowing Americans to buy health insurance across state lines, and then see what that one change alone does to the cost of insurance premiums across the nations. And best of all, that wouldn't cost the tax payers anything more than the paper on which they print out the bill.

Data from the American Medical Association shows that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.

The study also shows that in 166 of 294 metropolitan areas, or 56%, a single insurer controls more than half the business in health maintenance organization (HMO) and preferred provider networks (PPO) underwriting.

Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That mean...

Data from the American Medical Association shows that in each of 43 states, a handful of top insurers have gained such a stronghold that their markets are considered "highly concentrated" under Department of Justice guidelines, often far exceeding the thresholds that trigger antitrust concerns.

The study also shows that in 166 of 294 metropolitan areas, or 56%, a single insurer controls more than half the business in health maintenance organization (HMO) and preferred provider networks (PPO) underwriting.

Critics say that carriers are not only creating monopolies and oligopolies in many regions, they also control the other side of the equation in what is known as monopsony power. That means in addition to having the most enrollees, they're also the biggest purchasers of health care and can dictate prices and coverage terms. http://www.marketwatch.com/story/study-confirms-health-monopoly-fears

I’m pretty sure this is the ‘monopoly’ that Paul Krugman is referring to.

I’m pretty sure this is the ‘monopoly’ that Paul Krugman is referring to.

The one created by the government. This 'crisis' is of the government's doing. The only reason I can think of that they don't want to remove those barriers is to keep this manufactured 'crisis' in place until they can realize their real goal of a single payer government run health care system.

We need a "public plan" to provide "choice and competition" in the health insurance market.

Once again, we could provide choice and competition by removing restrictions put in place by the government. There are plenty of companies out there, but government restrictions mean people only have access...

I’m pretty sure this is the ‘monopoly’ that Paul Krugman is referring to.

The one created by the government. This 'crisis' is of the government's doing. The only reason I can think of that they don't want to remove those barriers is to keep this manufactured 'crisis' in place until they can realize their real goal of a single payer government run health care system.

We need a "public plan" to provide "choice and competition" in the health insurance market.

Once again, we could provide choice and competition by removing restrictions put in place by the government. There are plenty of companies out there, but government restrictions mean people only have access to a fraction of them. A public option wouldn't be real competition. It will have to be taxpayer funded and there is no way a private company can compete with one that has no bottom line.

Can anyone name a successful government program? The best is probably the post office (it was the one Obama came up with). It did well for a long time since it has a monopoly on mail service. But now that it has competition they are running in the red even though the price of stamps continues to escalate. And they are now talking about cutting services.

But isn’t regulation against the idea of a free market? I am under the impression that you are for a free market. Am I wrong? No offense if I am.

Regulation is the problem. You can't buy insurance across state lines. That goes against the constitution and is something the congress is supposed to regulate. They are supposed to ensure the free trade across state lines of goods and services, but laws currently on the books don't allow you to purchase insurance across state lines. If there is a monopoly in an area, it is most likely the government's fault.

Governments from state to state also mandate things that must be covered instead of leaving that up to the individual purcha...

But isn’t regulation against the idea of a free market? I am under the impression that you are for a free market. Am I wrong? No offense if I am.

Regulation is the problem. You can't buy insurance across state lines. That goes against the constitution and is something the congress is supposed to regulate. They are supposed to ensure the free trade across state lines of goods and services, but laws currently on the books don't allow you to purchase insurance across state lines. If there is a monopoly in an area, it is most likely the government's fault.

Governments from state to state also mandate things that must be covered instead of leaving that up to the individual purchasing the insurance. And individuals don't get the same tax breaks when they buy insurance that businesses do. These are due to government regulations that could be changed to make insurance cheaper and more accessible and increase competition.

Your argument has a lot of merit. It seems to me that IF competition is the primary goal then it would be a lot easier and more beneficial to consumers to allow insurance companies to sell health-care policies across state lines rather than erecting the seemingly impossible dream of a public option.

This idea has been around since 2005, I think, and if I recall correctly, the ideas against it don’t add up. Some states mandate insurance companies cover such expensive coverage as acupuncture, fertility treatments, hairpieces, etc. If consumers in that state could buy from insurers in another state that does not mandate such benefits then competition would produce a more rational regulatory en...

Your argument has a lot of merit. It seems to me that IF competition is the primary goal then it would be a lot easier and more beneficial to consumers to allow insurance companies to sell health-care policies across state lines rather than erecting the seemingly impossible dream of a public option.

This idea has been around since 2005, I think, and if I recall correctly, the ideas against it don’t add up. Some states mandate insurance companies cover such expensive coverage as acupuncture, fertility treatments, hairpieces, etc. If consumers in that state could buy from insurers in another state that does not mandate such benefits then competition would produce a more rational regulatory environment in all states.

I don’t see how the public would not benefit from a larger supply of affordable insurance.

However, if the true goal is to force everyone to have insurance, as evidenced by talk of penalizing anyone who does not buy coverage, then simply allowing a national market is not the answer. Any plan that engages in punitive action to make it work is not okay in my book.

I’m sure you and I both agree that the idea of the government forcing everyone to have insurance is repugnant. The end result would be to raise more money for the government and give the government more control over our lives.

If people don’t want to be responsible enough to get insurance then that is their business, I should not have to pay more taxes to force coverage for someone who doesn’t want it.

Regulation isn't the problem; it's the solution. Proper and enforced regulation will eliminate the problem that the US has now; it's insurance companies owned entirely by a single conglomerate of men, utterly destroying the concept of free market. This is why Teddy Roosevelt went around breaking trusts during his presidency — they rip off the American people, and keep the money clustered around the very rich, rather than in the still very fascist, but slightly more even distribution a free market would allow.

The idea that the government can't run anything well is a flat-out lie. Certainly, individuals in the system can add corruption and/or incompetence to the system, but so can ind...

Regulation isn't the problem; it's the solution. Proper and enforced regulation will eliminate the problem that the US has now; it's insurance companies owned entirely by a single conglomerate of men, utterly destroying the concept of free market. This is why Teddy Roosevelt went around breaking trusts during his presidency — they rip off the American people, and keep the money clustered around the very rich, rather than in the still very fascist, but slightly more even distribution a free market would allow.

The idea that the government can't run anything well is a flat-out lie. Certainly, individuals in the system can add corruption and/or incompetence to the system, but so can individuals in a private company, too. The very real fact is that the government is running hundreds of programs that don't get press coverage who are all doing a very good job at their tasks.

The fact that quotas and limits that need to be met to earn bonuses makes the whole private market innately corrupt, heartless and unethical.

The government is a much more trustworthy entity; at least the leaders of that group are held accountable by the public at the ballot box, unlike the greedy heads of private corporations.

If you want to show your protest with, say, 3M, how is an average joe going to get his point listened to? Contact them? They have systems designed to make enquiries disappear. Oh, buy stock, you say, and vote for board members? Right, I have to pay them to get them to listen to me; and even then, they'll only pay attention to me if I buy thousands of stock certificates in the company. That's called a Plutocracy. It's not supposed to be the American way, but it is. That is why you're a fool if you trust industry over the government.

Let’s agree that responsible regulation, without loopholes, without allowing any form of monopoly, and with strict enforcement, is the best solution. In an ideal world where this ‘perfect legislation’ could be passed I would be all for it. However, given the time-tested and proven track record of human nature when it comes to power and money (in politics and in business) there will always be corruption and/or incompetence, but they both will always be competent enough to find a way around any regulations. Take for example, Goldman Sachs.

I am not a fan of big corporations, particularly insurance companies, they are impersonal and will throw you to the wolves in order to keep the money in th...

Let’s agree that responsible regulation, without loopholes, without allowing any form of monopoly, and with strict enforcement, is the best solution. In an ideal world where this ‘perfect legislation’ could be passed I would be all for it. However, given the time-tested and proven track record of human nature when it comes to power and money (in politics and in business) there will always be corruption and/or incompetence, but they both will always be competent enough to find a way around any regulations. Take for example, Goldman Sachs.

I am not a fan of big corporations, particularly insurance companies, they are impersonal and will throw you to the wolves in order to keep the money in the pockets of the highest eschelon.

I am not a fan of big government either, it is too costly and far too inefficient, no matter the intentions of those at the top. Our leaders may in fact be held accountable at the ballot box but that does not stop them from wrecking havoc on our freedoms (you need look no further than George W. Bush/Dick Cheney to know this is true). Nor does it guarantee that they will look after our best interests over their own. Look at pretty much any politician to see this is true.

It is in the best interest of the entire country that we have a healthy populace and we need affordable health care to make it happen. If this requires regulation to force health care providers to follow through on their obligations no matter what medical malady befalls their policy holders then so be it.

I believe all of us should be given the option to choose whatever health plan we want whether it be backed by the federal government or not, as long as it is guaranteed they will not run out on us when we need them most. But I don’t believe I should have to pay for someone else’s policy.

The actual Health Care Providers have stepped up, and given lots of input toward the creation of the various versions of the bill. Doctors, nurses and other healthcare professionals desperately want this bill to go through — no human being can feel good having to say no to a person who desperately needs healthcare. They just want to be able to do their jobs, without a bunch of Insurance Agency Bureaucrats double-guessing their decisions for reasons that have nothing to do with medicine. That's why America needs full Universal Healthcare; in the nations with it, that situation just doesn't exist and doctors are free to do whatever tests and treatments the patient needs without waits or possib...

The actual Health Care Providers have stepped up, and given lots of input toward the creation of the various versions of the bill. Doctors, nurses and other healthcare professionals desperately want this bill to go through — no human being can feel good having to say no to a person who desperately needs healthcare. They just want to be able to do their jobs, without a bunch of Insurance Agency Bureaucrats double-guessing their decisions for reasons that have nothing to do with medicine. That's why America needs full Universal Healthcare; in the nations with it, that situation just doesn't exist and doctors are free to do whatever tests and treatments the patient needs without waits or possible refusals.

Current stats show that the top Medical Insurance Companies are refusing over 20% of claims since the beginning of 2009. That's 1 person in 5 that is not getting the tests and/or treatments they need. As much as people bitch about imagined evils of "Big Government", you just don't get that with government healthcare. It's a non-issue. Unless a test or treatment isn't currently recognized by the top medical association for being too new to assess or has proven to be much too high risk, then a doctor is free to do it.

When you look at the pros and cons of trusting government vs. trusting corporations, the government just comes out way on top. Government's not perfect, given; but their citizen-based methodologies are still a vast improvement over Corporations' profit-based methodologies.