Everyone would be required to depend on a single government plan.

The existence (or not) of supplemental insurance would not negate their monopoly status.

It’s like if ATT were the only company that provided landline telephone, but you could get internet service from a variety of providers. ATT still would be considered a monopoly.

Monopolies have no incentive to hold down costs or provide quality service.

In addition, do you really want Congressmen handing out $ for medical equipment, clinics, funding for specialists, etc in the same manner that they horse trade for roads and bridges in pork spending bills today?

Don’t kid yourself, that’s how it will be handled.

Americans deserve better than that.

Whatever happened to the liberals who used to say that they didn’t want the government in the room when a doctor and patient were making medical decisions?

If the government holds the purse strings to your health plan, then they are ALWAYS in the room, and not as a passive viewer either.

Or do you just assume that price fixing is taking place?

If two breakfast cereal companies charge a similar amount for a box of cereal, are they engaged in price fixing?

Or do they both pay amount about the same rate for employee wages, and encounter similar costs for the items they buy (grain, cardboard for the box, printing costs, advertising rates on TV, transportation costs, etc) to manufacture and market their product?

The link you provided had no examples of “one insurance company that has 80 -90% of the business”. None. Zero.

Instead of the article supporting your assertion, it refutes it.

Here’s a portion of an article that underlines what I’m talking about:

As James C. Robinson pointed out (PDF) at the end of 2004, in 16 states the dominant health insurance company accounts for at least 50 percent of private insurance enrollment, while in 40 states the top three health insurance companies account for between 60 and 100 percent of the market. He gives some background behind this phenomenon:
“The emergence of managed care in the 1980s was accompanied by the creation of hundreds of health insurance plans—mostly health maintenance organizations (HMOs)—which forced the incumbent indemnity insurers to reduce their costs or lose their customers. The subsequent senescence of managed care has been accompanied by an equally remarkable shrinkage in the number of competing health plans, as small firms sold out to their larger rivals and as even some of the industry’s biggest names disappeared in a wave of mergers and acquisitions. In the past year, for example, UnitedHealthcare has acquired Oxford Health Plans, and Anthem has announced the acquisition of WellPoint, creating megaplans with twenty-two million and twenty-eight million enrollees, respectively.”

Dr Thompson,

Can you point to any state that is only served by 1 insurance company? That would be a monopoly.

If there is more than one option , a monopoly doesn’t exist, so let’s be accurate.

btw , your pet project — the single payer system — is by definition a monopoly.

So how come you want to establish a government monopoly that would have no incentive to keep prices under control?