The insurance industry received an exemption to America's antitrust laws in 1945. Only one other enterprise - major league baseball - ever won such special treatment.

Called the McCarran Act, that exemption left "regulating the business of insurance" entirely to the states. State regulators were to keep close tabs on the industry and protect consumers. Over time, those regulators became captives of industry, approving almost every rate increase filed.

Today, the premium shocks administered by health insurance companies to their best customers are a massive drag on a depressed economy. Employers and unions, families and individuals, all rage against double-digit rate increases.

Negotiations become more acrimonious. IAM members rightfully object to employers simply passing along higher health care costs. Their employers argue they have no other recourse when, in fact, they do have viable options: absorb the increases or help us reform this inane system.

This IAM Journal explores this tangled mass of competing interests. Unlike the Gordian knot severed by Alexander the Great, these premium shocks have no clear-cut solution.

But, as a resolution offered last November by the Washington delegation to the American Medical Association's House of Delegates suggests, repeal of the McCarran Act "would make it more affordable for all purchasers of heath care."

Perhaps it is time for doctors, corporate executives and union leaders to work towards that objective.