Trial courts have blocked two health insurance mergers that would have created what the president of the American Medical Association (AMA) described as "a threat to the affordability, accessibility and quality of health care.”
AMA President Andrew Gurman, wrote an
opinion piece for the AMA’s online publication AMA Wire recently.
prevent Anthem from acquiring Cigna and Humana from merging with
are victories of great magnitude for our patients and the health care
system,” Gurman said. “They are the result of one important
factor — that physicians came together to protect patients, our
profession and our health care system from further consolidation.”
Gurman also said
the Anthem court rightly decided that “an enhanced ability to
coerce physicians to accept lower reimbursement is not an efficiency
defense, would not benefit patients, and ‘would erode the
relationship between insurers and providers’ and ‘reduce the
collaboration’ that is essential to innovation in payment and
Gurman testified in a judiciary committee in
2015 and said he saw a strong resistance build over the next 15
months among those in the medical profession. He argued that people
in the courtroom were particularly interested when he was called upon
following others who were not part of the medical community.
“They wanted to
know who was the doctor in the room,” Gurman said. “And that goes
to show you that, when physicians are in a position to speak up for
our patients and ourselves, people listen.
Gurman told the
court that an Aetna-Humana merger would erode competition in Medicare
Advantage plans across more than 350 U.S. counties.
District Judge John D. Bates also set a notable legal precedent by
recognizing Medicare Advantage as a separate and distinct market that
is not in competition with traditional Medicare — a major focus of
our efforts," Gurman said. "We are pleased with Judge
Bates' further conclusion that the Aetna-Humana merger would have
substantially lessened competition in the sale of individual
commercial insurance on the public exchanges in three counties in
AMA applauds rejection of health insurance mergers
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