Wis. Blues: Do healthcare monopolies add to the ranks of the uninsured?
Blue Cross and Blue Shield United of Wisconsin wants to know. The plan, famous for its antitrust lawsuit against Marshfield (Wis.) Clinic, recently mailed requests for study proposals to academics nationwide.
Just 7.3% of Wisconsin residents didn't have health insurance in 1994, the lowest rate in the nation. But significant variances existed between regions in the state. For example, in northern Wisconsin, a territory that includes Marshfield, the uninsured rate was 11%, according to the Wisconsin Department of Health and Social Services.
In 1994, the Blues accused Marshfield Clinic of running an illegal monopoly in north-central Wisconsin. The Blues won the case, although most of the claims against the 450-physician clinic were overturned on appeal. Marshfield was found guilty of conspiring to divide its market with competitors. A trial to determine damages has been scheduled for April.
Last week, the clinic completed merger negotiations with Wausau (Wis.) Medical Center, a group practice of 73 physicians. Wausau is about 40 miles northeast of Marshfield. Federal Trade Commission approval is required.
The Blues says its new study isn't part of a vendetta. "The fact that rates are higher in the Marshfield area has nothing to do with the fact that we want to find out why there are variances," Blues spokesman Tom Luljak said.
Proposals are due Jan. 15, and the target for completing the study is next October. A budget hasn't been set.
Researchers are being asked to consider how the cost of healthcare, the regulatory environment and the job market affect uninsured rates in Wisconsin and elsewhere.
Andy Weir, an analyst at the Marshfield Medical Research Foundation, a division of Marshfield Clinic, said the Blues study addresses an important issue. But Weir questioned the state data that show higher uninsured rates in northern Wisconsin. The sample size is too small and the rate of error too high for the results to be statistically significant, he said.
And if more Marshfield-area residents really lack insurance, that's probably because of higher unemployment rates rather than lack of provider competition, Weir said.