Below are excerpts from an op-ed that appeared in the April 24 San Jose Business Journal. It was written by B.J. Snell, immediate past chairwoman of the political and economic affairs section of the American College of Nurse Midwives.

"Congress is preparing to consider antitrust legislation that could dramatically increase provider incomes – at the expense of patient access to care.

"H.R. 1304 – the Quality Health Care Coalition Act of 1999 – seeks to allow certain health professionals to bargain collectively without forming a union or other legitimate collective bargaining unit. This would, in effect, exempt those professionals from antitrust laws. . . .

"Rather than protecting patients’ rights or ensuring that the legitimate concerns of health care professionals will be addressed, it provides incentives for health care professionals to engage in price fixing, boycotts and market allocation agreements that would otherwise be illegal under the antitrust laws.

"Under this bill, nothing would prevent all of the doctors in a market from combining into a cartel and demanding exorbitant fee increases at the expense of their patients and the taxpayers who fund Medicare and Medicaid. . . .

"Nonphysician providers (who include nurses, nurse midwives, nurse practitioners, nurse anesthetists, social workers and physical therapists) have been shown repeatedly to provide equal, if not better, services with equivalent or better outcomes when compared with physician care. In addition, such providers have demonstrated better cost effectiveness.

"But under H.R. 1304, physician cartels would be able to negotiate unfair and exclusionary agreements with health plans that could harm other providers.

"Simply put, an antitrust exemption is not the right medicine for the health care system."