For consumers, more competition is generally better than less competition. For that reason, the proposed merger of the state's two largest health insurers, Highmark, Inc., of Pittsburgh and Independence Blue Cross of Philadelphia, should raise serious questions.

Because of the potentially negative impact on millions of Pennsylvanians, it is appropriate that state Sen. Don White, R-Indiana, has sponsored a bill to give the state Department of Insurance more authority over such mergers.

If approved, the combined insurance giant would insure about 7.5 million of the state's 12 million people. Allowing a single company to have such a dominant market position should concern everyone — from consumers to doctors, hospitals and also other insurance providers.

Even if the merger would not dramatically change the two companies' already considerable clout, it still would create a near monopoly situation that could have negative consequences for health care providers and consumers.

If the merger is allowed to stand by state officials, the yet-to-be-named company would be the third-largest in the U.S., behind UnitedHealth Group of Minneapolis and Wellpoint, Inc., based in Indianapolis.

White and his like-minded colleagues in Harrisburg are not the only people concerned about the impact of the ongoing consolidation of health insurers. Congress is looking at the trend, and a report by the Government Accountability Office (GAO) found that in most states the largest insurer controls nearly half the market. In nine states, the largest carrier, normally a Blue Cross and Blue Shield company, controls more than 50 percent of the market. That should raise concerns across much of the U.S.

White, an insurance broker for 27 years prior to coming to Harrisburg, is right to raise concerns over what he described as a "multibillion-dollar mega-entity." State regulators should have more say in blocking any move that could harm consumers or serve primarily to raise profits at companies whose profits already strain the definition of "nonprofit."

The super-sizing of these giant health care insurers would give the combined company an even greater ability to squeeze both ends of the health care equation — hospitals and doctors as well as policy purchasers — to further increase profits.

And increased profits at these nonprofit organizations are huge. Highmark's 2005 profits topped $315 million and it now carries a surplus of $2.8 billion. Independence earned profits of about $144 million for 2005 and saw its reserves move up to $1.43 billion.

In recent years, many people across the state have questioned the massive reserves held by these companies and suggested that lower reserves would allow for price reductions for consumers — both employers and individuals buying coverage directly.

A merger of Highmark and Independence creates a giant that would further diminish competition in a state that already suffers from not enough health insurance competition.

This merger should be carefully reviewed by state regulators before it is allowed to go forward.