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As followers of the health reform debate know, today the Senate Finance Committee voted down 15 to 8 a measure to include a public insurance option to the Senate bill.

All 10 Republican members of the committee voted against the amendment, introduced by Sen. "Jay" Rockefeller (D-WV), which includes what advocates call a "robust public option."

Five Democrats also voted "nay": Max Bacus of Montana, Tom Carper of Delaware, Kent Conrad of North Dakota, Blanche Lincoln of Arkansas and Bill Nelson of Florida.

Yet these Democrats represent states that may be most in need of a public insurance choice to compete with private plans:

Four out of five of the Democrats who voted "no" on Rockefeller's amendment come from states where one insurance company controls 42% or more of the market -- a level of market dominance that the Department of Justice legally defines as "highly concentrated."

Here are how these senators' states rate for insurance market concentration:

STATE -- % OF MARKET CONTROLLED BY BIGGEST COMPANY*

NORTH DAKOTA -- 89% controlled by Noridian/Blue Cross Blue Shield ND
ARKANSAS -- 75% of health insurance market controlled by Blue Cross Blue Shield AR
MONTANA -- 75% controlled by Blue Cross Blue Shield MT
DELAWARE -- 42% controlled by CareFirst/Blue Cross Blue Shield
FLORIDA -- 30% controlled by Blue Cross Blue Shield FL

Only one of the Democrats -- Sen. Bill Nelson from Florida -- comes from a state without a "highly concentrated" health insurance market, although it's notable that the state's top two insurers (BCBS and Aetna) together control 45% of the market.

Nation-wide, 94% of insurance markets are near-monopolies -- and as Facing South reported earlier, the metro area with the worst concentration in the country (Texarkana, 97%) falls in the district of fierce public option opponent and Blue Dog Rep. Mike Ross (D-AR).

* Most of this data can be found in the American Medical Association's 2007 report on competition in health insurance [pdf]; the North Dakota figures come from this recent report published by Health Care for America Now! Note that North Dakota figures include accident and health coverage.

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Originally posted to ProgressiveSouth on Tue Sep 29, 2009 at 01:45 PM PDT.

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Comment Preferences

    •  3 of those are in the top 10 (0+ / 0-)

      Arkansas, Montana and North Dakota are among the 10 most concentrated health insurance markets in the country.

      Seems like these are the kind of places that could use a public option.

      Blogging for a Progressive South // www.southernstudies.org

      by ProgressiveSouth on Tue Sep 29, 2009 at 02:23:50 PM PDT

      [ Parent ]

  •  Best Senators you could ever buy... (4+ / 0-)

    for the Insurance companies!

    The Southern Strategy, is alive and well in the Republican Party, and their Terrorist Recruitment Campaign is well underway.

    by cyeko on Tue Sep 29, 2009 at 01:48:01 PM PDT

  •  just got a fund raising letter from "Bob" Menende (2+ / 0-)
    Recommended by:
    eztempo, possum

    I told him I would not give any money to the DSCC until they defunded the 5 dem that voted against the public option. No money for health care whores.

  •  42% isn't that big of a deal... (0+ / 0-)

    I'd knock off Delaware and FLA and just focus on the three states with 75% or greater.  Carper and Nelson voted for the Schumer PO.  

    STATE -- % OF MARKET CONTROLLED BY BIGGEST COMPANY*

    NORTH DAKOTA -- 89% controlled by Noridian/Blue Cross Blue Shield ND
    ARKANSAS -- 75% of health insurance market controlled by Blue Cross Blue Shield AR
    MONTANA -- 75% controlled by Blue Cross Blue Shield MT

    Also look how many bribes they've accepted  from health insurance industry also known as campaign contributions...

    •  The DOJ disagrees (5+ / 0-)

      Every market is different (and health insurance is one of the most unique of all), but officials came up with the 42% figure for a reason -- it translates into a level of critical mass a company has that can help shape the rest of the market.

      The AMA report is especially interesting because it looks at what control the top 2 companies have in the HMO/PPO market. In DE it's 65% of the top 2, which with sufficient collusion could definitely determine the options available to consumers.

      Blogging for a Progressive South // www.southernstudies.org

      by ProgressiveSouth on Tue Sep 29, 2009 at 01:56:46 PM PDT

      [ Parent ]

    •  Those w/ most dominant carriers... (0+ / 0-)

      ...are probably the most "bought" by their home town monopoly, don't ya think?  That makes them very tough nuts to crack.

      Better to start floating a primary challenger's name in media they look at:  write a letter to the editor of the State Capital's newspaper imploring a strong challenger to throw his or her name into the ring (and mention them by name).  Blog onto your State's most read political blog ... you know what to do.

  •  I wrote about this. (3+ / 0-)

    The main obstructionists are the very democrats from small states who have one maybe, two insurance companies.  This means the citizens have NO CHOICE but to deal with this crapola insurance.  This is another reason why the insurance companies are fighting hard to keep the status quo just the way it is and these weak kneed democrats are bought and paid to do what these insurance companies TELL THEM TO.  Too much money in this.

    http://www.dailykos.com/...

    •  This is who AHIP represents (0+ / 0-)

      as well as various other lobbies and institutions created to defend the health insurance status quo.

      Whether or not BCBS in any given state gives a lot of money to a senator is almost beside the point. The entire army of health insurance operatives are determined to make sure they control market share. Period.

      Blogging for a Progressive South // www.southernstudies.org

      by ProgressiveSouth on Tue Sep 29, 2009 at 01:59:29 PM PDT

      [ Parent ]

  •  Can we please (3+ / 0-)
    Recommended by:
    Iberian, eztempo, DocGonzo

    Please find strong primary challengers to these traitors?
    If we can't make these folks pay big time at election time, then we might as well just consider democracy dead.

  •  Senators need big media buys (2+ / 0-)
    Recommended by:
    ProgressiveSouth, eztempo

    And the insurance monopolies need to buy Senators to keep their monopolies. It's a system in equilibrium.

    Campaign finance reform is needed to fix the problem.

    Small population states with large physical areas are especially vulnerable to this dynamic. Noridian is very powerful in ND and they provide key funding for senate races. Conrad can't buck Noridian.

    And Baucus bucks us.

    look for my DK Greenroots diary series Wednesday evening. "It's the planet, stupid."

    by FishOutofWater on Tue Sep 29, 2009 at 02:03:44 PM PDT

  •  Traitors need to go (0+ / 0-)

    Max Bacus of Montana
    Tom Carper of Delaware
    Kent Conrad of North Dakota
    Blanche Lincoln of Arkansas
    Bill Nelson of Florida.

    This guys need to feel the heat, the are the worst kind of politicians, and we will remember the names.

    I'm surprise by Tom  Carper. Contact this enemy of your family health care and make clear you are going to fund any primary challenger

    Washington, D.C. Office:
    513 Hart Senate Office Building,
    District of Columbia 20510-0801
    Phone: (202) 224-2441
    Fax: (202) 228-2190

    Wilmington Office:

    301 North Walnut Street, Suite 102L-1
    Wilmington, Delaware 19801
    Phone: (302) 573-6291
    Fax: (302) 573-6434

    Baucus/Enzi/Grassley for your money against your health

    by Iberian on Tue Sep 29, 2009 at 02:17:16 PM PDT

  •  A Progressives escrow account could collect (1+ / 0-)
    Recommended by:
    eztempo

    a lot of money that won't go to the Democratic House and Senate reelection committees unless there is a robust public option. This might put some spine in the leadership. And if there is not a public option then that large sum of money will go to any progressive Dem that runs against the damn Bluedog that helped vote the PO down.
    Hey Markos, this probably has to register separately from existing funds like ActBlue but could coordinate with them to leverage the amounts contributed in the big primaries. But since it seems the Pocket Dems are often from small states, the money will go a long way, particularly in the Senate races. Maybe this won't amount to more than seed money for some races but at least it will come from non-corporate sources (us).

    Health is the first requisite after morality - T. Jefferson

    by OHdog on Tue Sep 29, 2009 at 02:18:39 PM PDT

  •  We need direct action (0+ / 0-)

    We have voted, rallied and blogged, it's time to boycott.

    No Health Care, No Christmas.

    We shall overcome, someday. Yes we can.

    by Sam Wise Gingy on Tue Sep 29, 2009 at 02:21:50 PM PDT

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