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The following is a link to the American Medical Association study in 2007 on concentration in local health insurance markets - good reading.
http://www.ama-assn.org/ama1/pub/upload/mm/368/compstudy_52006.pdf
I found the chart below fascinating: the unemployment rate has increased 34% since January of 2009:
I will have some observations as I read through the document but meanwhile, here is the link.
http://www.federalregister.gov/OFRUpload/OFRData/2009-26502_PI.pdf