Antitrust

ANTITRUST

The antitrust laws are crucial to promoting competition in the marketplace. The Quality Health Care Coalition Act, H.R. 1304, would allow certain health care providers who are not organized in labor unions to bargain collectively with the same treatment under the antitrust laws as unions when negotiating with health plans and insurers – without having to unionize. This would jeopardize the fundamental mechanism for ensuring vigorous competition to the benefit and protection of consumers.

The antitrust exemption in H.R. 1304 would represent a radical departure from current labor law standards.

The National Labor Relations Act differentiates between "employees" and "independent contractors."
Current law already extends a labor exemption from antitrust law for bona fide labor organizations and covers health care providers within the employer-employee context.
The relationship between self-employed health care providers and health plans differs markedly from that between an employee and employer.
The NLRB recognized this difference in rejecting the claim of one group of physicians, pointing out that only a minority of doctors' incomes come from a health plan and only a minority of their time is spent serving that plan's patients.

HLC POSITION

Changing the antitrust law is not necessary. It would hinder competition and increase costs. Health care providers who are concerned about health care quality and competition already may create joint ventures and bargain collectively with health plans through those ventures.

The 1996 Fedral Trade Commission guidelines allow – even encourage – such arrangements and negotiations to proceed if the joint price-setting arrangement passes the "rule of reason" standard. Under the "rule of reason," the group must be sufficiently integrated and the anti-competitive effects of these joint negotiations do not outweigh consumer benefits, such as increased efficiency.