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Oligopsony (the market condition when few buyers can greatly influence price and other market factors) gives the insurance companies (buyers) tremendous negotiating power and prevents physicians (sellers) from addressing unfair payment practices. To solve this problem, all fifty states have instituted a law penalizing health insurers for late payments. In the past ten years, state courts have imposed at least $76 million in fines against insurance companies for failure to comply with prompt-pay laws, according to the AMA. The settlements between seven largest insurance companies and state medical societies amounted to more than $1.53 billion, with only $384 million for direct payments to physicians (see Dave Hansen, "The failed promise of prompt pay," AMNews, Nov. 5, 2007).

An oligopsony, according to Wikipedia, is a market form in which the number of buyers is small while the number of sellers could be large. It's a mirror opposite to an oligopoly, where there are many buyers but just a few sellers:

World economy: Three firms (Cargill, Archer Daniels Midland, and Callebaut) buy the vast majority of world cocoa bean production, mostly from small farmers in Third World countries.

American economy: tobacco growers face an oligopsony of cigarette makers, where three companies (Altria, Brown

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