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Antitrust Relief State Action Doctrine amendment talking points Addressing a national problem with federal solution H.R. 1304, the “Quality Health-Care Coalition Act of 1999,” is the solution for patients and health care professionals. H.R. 1304 would ensure that physicians and other health care professionals can act as effective advocates for their patients by amending the federal antitrust laws to allow health care professionals to jointly negotiate with health plans. Congress has the authority to carve out exemptions to the federal antitrust laws when they -- or the manner in which they are enforced -- impede other important policy objectives. That is what Congress did when it enacted antitrust relief for employee negotiations with employers, agricultural cooperatives, and fisherman's cooperatives. H.R. 1304 addresses similar dynamics involved in negotiations between physicians and health plans. Only federal legislation can uniformly address this disparity in negotiating power. The State Action Doctrine is a limited alternative to the real solution. Similar legislation recently proposed in some states under the State Action Doctrine has been gaining interest as an option. That judicially created doctrine allows states to enact specific legislation to, in effect, “amend” application of federal antitrust laws in the state. This type of legislation is a crucial step in the right direction for improving the quality of health care for patients in this country, but it has serious limitations. The State Action Doctrine requires extensive state regulation that necessitates a highly regulatory structure. As a consequence, negotiations would be allowed only under very strict circumstances. For instance, the number of physicians or health care professionals allowed to negotiate with health plans would be very limited; the subject matter of negotiations would be highly restricted; and the state attorneys general would be required to be extensively involved. In addition, there are major hurdles to State Action Doctrine legislation. Opponents of extending health care professionals the ability to negotiate fair contracts are already threatening to challenge these laws as not fitting the requirements of the State Action Doctrine. They claim that the negotiations under the proposed laws would not be regulated enough! They claim that the states must actually set the terms of the contracts - not just oversee the negotiation process. A simple federal solution is clearly the preferred approach to remedy this national problem. H.R. 1304 is the ultimate goal for improving the quality of health care for patients in this country. By and large, physicians strongly prefer the simple solution in H.R. 1304. It allows the parties to deal with the particular issues they face in their market on a voluntary basis without another regulatory bureaucracy. Printer-friendly version Published Mar 16 2000 Return to Antitrust Relief