ANTITRUST COALITION FOR CONSUMER CHOICE IN HEALTH
CARE
555 THIRTEENTH STREET, N.W.
Suite 12E-405
WASHINGTON, D.C.
20004
(202) 637-8609
May 24, 1999
Dear Representative,
The Antitrust Coalition for Consumer Choice in Health Care
("ACCCH") -- which is a broad coalition of employers, health plans, health care
professionals and others involved in the purchase, management and delivery of
health care services -- is opposed to H.R. 1304, the "Quality Health-Care
Coalition Act of 1999."
The bill creates a sweeping antitrust exemption that will
permit price-fixing, boycotts and market allocation agreements that would
otherwise be illegal under the antitrust laws. Such agreements will
result in higher health care costs and fewer choices for patients, employers,
and the Medicare and Medicaid programs. Also, such agreements will permit
cartels to negotiate unfair and exclusionary agreements with health plans that
could put nonphysician providers, in particular, at an unfair competitive
disadvantage by limiting their opportunity to compete for patients.
ACCCH's opposition to H.R. 1304 is based on the following:
- The bill would increase health care costs and put non-physician providers
at an unfair competitive disadvantage. Competition is crucial to keeping
health care costs under control in the private sector, as well as in the
Medicare and Medicaid programs. The bill would eliminate competition by
permitting health care professionals to engage in price-fixing, boycotts and
market allocation agreements that otherwise would be illegal under the
antitrust laws. Under the bill, for example, nothing would prevent all the
doctors in a market from combining into a single cartel and demanding
exorbitant fee increases or exclusionary terms and conditions that limit the
participation of nonphysician providers or otherwise impair their ability to
compete for patients.
- An exemption is not needed to permit physicians to organize in ways
that will benefit consumers or to discuss legitimate quality of care issues.
As explained in the 1996 Health Care Antitrust Guidelines issued by the
federal antitrust agencies, physicians and other care professionals can
organize networks and other kinds of joint ventures to contract or compete
directly with health plans. Moreover, physicians are permitted to collectively
discuss issues involving quality of care with health plans or to bring such
issues to the attention of the public without violating the antitrust laws.
- The bill is inconsistent with the labor antitrust exemption granted to
other workers. The existing labor antitrust exemption seeks to balance the
importance of competition with our national labor policy. Although such labor
negotiations enjoy an antitrust exemption, they are subject to strict rules
governing the rights and responsibilities of both workers and employers and
are overseen by the National Labor Relations Board ("NLRB"). The antitrust
exemption in H.R. 1304 is even broader than that for labor negotiations and
provides for no oversight of the negotiations by the NLRB or any other
government agency.
ACCCH opposes H.R. 1304 because it will increase the cost of
health care, put some health care professionals at an unfair competitive
disadvantage and leave cartels of health care providers without any oversight
from a regulatory authority. Moreover, such an exemption is unnecessary because
health care professionals are already permitted under the antitrust laws to
discuss legitimate quality of care issues among themselves and with health
plans. They can also form efficient joint ventures that increase their
bargaining power while protecting the ability of employers and consumers to
choose among a variety of health care plans and providers.
ACCCH urges you to oppose H.R. 1304.