---
title: Single Payer Bogey Man
description: Single Payer Bogey Man
---

[Confessions of a Pediatric Management Consultant... Where fame and fortune await those who help keep pediatric practices alive and independent! ](https://chipsblog.pcc.com)

# [Single Payer Bogey Man](https://chipsblog.pcc.com/single-payer-bogey-man)

 Written by [Chip Hart](https://chipsblog.pcc.com/author/chip-hart) | Mar 9, 2010 4:17:08 PM

For the record, I'm not in favor of a single-payer system.  But I'm also not a fan of much of the rhetoric that I hear against the concept.

In particular, I have always wondered why those advocating for the strength of choice aren't presently railing at the *lack* of payer choice for both physicians in patients in so many places.  I remember my first time confronting this when I was in Rochester talking to some practices about insurance negotiation and they asked, "What if the plan represents 75% of my business?"

How, on earth, is a plan covering 75% of the lives in a given metro area, or state, not an acute example of restraint of trade?

The AMA wonders too.  From a sadly eye-opening article:

> One insurer held 70% or more of the health plan market share in 24 of 43 states measured, up from 18 in 42 states in the previous year's study. In 92% of the 313 markets in the report, one insurer held at least a 30% share.

Read the [rest of the article](http://www.ama-assn.org/amednews/2010/03/08/bil20308.htm) - crazy!  Look at the concentration in some of those markets, so often by the local BCBS plan.  60-100%!

If I were in charge of health care reform, this is where I'd start.

[View full post](https://chipsblog.pcc.com/single-payer-bogey-man)

```json
{
  "@context" : "http://schema.org",
  "@type" : "BlogPosting",
  "author" : {
    "@type" : "Person",
    "name" : "Chip Hart"
  },
  "dateModified" : "2021-09-16T13:55:31.456Z",
  "datePublished" : "2010-03-09T16:17:08Z",
  "headline" : "Single Payer Bogey Man",
  "image" : {
    "@type" : "ImageObject",
    "height" : 60,
    "url" : "/hs/hsstatic/content_shared_assets/static-1.4092/img/default-amp-logo.png",
    "width" : 60
  },
  "mainEntityOfPage" : "https://chipsblog.pcc.com/single-payer-bogey-man",
  "publisher" : {
    "@type" : "Organization",
    "logo" : {
      "@type" : "ImageObject",
      "height" : 60,
      "url" : "/hs/hsstatic/content_shared_assets/static-1.4092/img/default-amp-logo.png",
      "width" : 60
    },
    "name" : "Confessions of a Pediatric Management Consultant"
  }
}
```