Health merger might not be good for all

Saturday, Sept. 1, 2007 | 8:02 a.m.

On the surface, Monday's decision to approve Sierra Health's buyout by UnitedHealth implies protections for current Sierra customers. No premium increases, no degrading of claims handling, etc.

But it depends on which Sierra customers are being considered. Sierra's Senior Dimensions is a managed care, limited panel program serving thousands of Nevadans who don't pay premiums or submit claims. Thus, the only condition applying to them is presumably no services cutback.

UnitedHealth owns Senior Dimension's only area competitor, Secure Horizons. Many more citizens have chosen Senior Dimensions, believing its offerings are better, including copayments and prescription drug costs.

Following the merger, would one expect UnitedHealth to be in competition with itself? Or rather, would it logically want to adjust Senior Dimensions benefits to emulate Secure Horizons, based on its own perception of what is good business within our market?

Even Sierra makes changes at various times ... changing the drug formulary, dropping services, adding others, altering copayments. How will the Insurance Division differentiate sound changes from those imposed by the new owners to ultimately homogenize the two current ly competing plans?

Gov. Jim Gibbons suggests the protections do not go far enough and urges Nevada's attorney general and the U.S. Justice Department to intercede. In other words, monopolistic situations are rarely good for the consumer. Let us hope they do intercede, until all member groups within the merged company are fully protected.