THERE IS DISTURBING NEWS in a National Business Group on Health survey released last week.

As we report on page 3, surveyed members estimate their health care plan costs will increase an average of 8.9% in 2011. That's up from the 7% increase they project for this year and the 6% to 6.5% annual cost increases that have been typical for the past several years.

One reason costs are expected to rise more next year than the recent norm is the result of changes employers will have to make to their plans to meet requirements of the health care reform law.

Expanding coverage obviously will drive up costs.

But the changes mandated by the reform law account for only a small portion—roughly one percentage point—of the increase that employers anticipate in 2011, said NBGH President Helen Darling. The bulk of the increase will be the result of medical care providers increasing their charges.

One has to wonder, in a down economy and at a time when the costs of many other goods and services have fallen or are remaining flat, why the cost of health care services keeps going up.

We think a major reason is that, through mergers and consolidation, providers, especially hospitals, face little competition in the markets in which they operate.

Certainly, this is something that antitrust regulators need to examine more carefully than they have previously. Health care reform will turn out to be a sham if costs rise so high that employers no longer can afford to provide coverage and the taxes needed to subsidize coverage for the uninsured become prohibitive.