Using NC law to break up the monopoly BCBS has in NC

or take them over?

BCBS is a corporation pure and simple, and they are a monopoly. It's hard to make the case that the NC constitution would not apply here.

Of course, if the insurer were owned by we the people as a public insurance plan with transaction processing and operations outsourced to the Blues back office, the monopoly challenge wouldn't apply. The state already operates several monopolies, the Exploitation Lottery, for example.

Fascinating idea.

Antitrust law seems less concerned with how a company is organized and more concerned with the extent of its control over a particular market.

Insurance companies are immune from liability under federal antitrust law. However, BCBS of North Carolina only issues policies to North Carolina residents. Therefore, if it is organized as a separate entity under North Carolina law, I can't foresee a reason that would prevent the state from using its authority to pursue more competition, especially in the non-employer provided market.

Many people might make comparisons to utilities in NC and how those are monopolies. And they'd be right. The difference, however, is that rate increases must be approved by the State before utilities can raise prices, power which the state does not have for health insurance.

BCBS controls, by some accounts, as much as 98% of the individual health insurance market in NC. It appears to be a monopoly by even the most strict of definitions.

Great blog post. It’s useful information.

court books

It would be interesting to compare work insurance pools, because it's the exact opposite cost position at other places in the state.

Of course, this is the whole reason employer-based insurance pools are inefficient. It would be cheaper if everyone were in the same pool (that's single-payer).

your point may be valid. OTOH, there is no (to my knowledge) consumer oriented repository of info available covering the various plans and providers. Federal employees do have a site available that covers everything and they have a plethora of options...which we, the taxpayers, heavily subsidize. And Congress, of course, gets loads of free health care thru a network of clinics manned by the Navy. You can read about it HERE

You also fail to consider the many other aspects of why our system needs reform...and how it got to be in the mess it's in.

Why is it a felony to order prescription drugs from a pharmacy outside the US? Do you think it might be because Congress is protecting big pharma's profits? Why is it that insurers get to decide not just what they'll pay, but whether they'll pay anything at all for a non-elective procedure? Why is it that insurers often delay approvals and/or claims processing beyond any reasonable time periods? Why is it that Health Care insurance executives are often paid more in a day than the average family earns in a year?

Why is it that if Medicare reimbursed more for a procedure/treatment than the private co-insurer, the co-insurer can actually charge back that overage to the physician and then make the patient pay the difference?

The truth is, it's a quagmire...and sick people don't need the aggravation.

I could go on... Most of us, not being dumber than a barrel of hair, already understand how our insurance plans work...assuming we're fortunate enough to have insurance.