the notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false.

The report

uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

HCAN describes the situation as "a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments

one former top Federal Trade Commission official

has sent a letter to the Justice Department's Antitrust Division, asking for an investigation into the health insurance marketplace.