Optimizing Private Antitrust Enforcement in Health Care

Americans are paying too much for health care services and insurance, in large part due to insufficiently competitive markets. Waves of consolidation have fortified providers and insurers with market power, resulting in higher prices and lower quality for consumers. As antidotes, advocates have proposed various legislative, regulatory, and enforcement solutions. Yet, unlike public antitrust enforcement, private antitrust enforcement is either not mentioned or criticized as sour grapes from competitors or a money grab by consumers. Instead of ignoring or bashing private litigation, those looking to address the health care pricing crisis in the United States should be looking to optimize it. Effective private enforcement can restore competition, deter antitrust violations, and compensate victims in the markets for health care services and insurance. For plaintiffs, the key to optimizing private antitrust enforcement is overcoming the unavoidable challenges in litigating these cases—from satisfying pleading standards and establishing standing, to defining relevant markets. This article explains the key obstacles involved in these cases and tracks recent and current plaintiffs whose experiences provide insight

America\u27s Public Hospitals and Health Systems, 2003: Results of the Annual NAPH Hospital Characteristics Survey

In 2003, members of the National Association of Public Hospitals and Health Systems continued to offer millions of uninsured and underserved individuals access to the medical services so critical for lifelong health and well-being. Delivering these services was difficult, however, given the economic downtown early in the decade and the resulting inadequacies associated with safety net financing. This report examines the operations and activities of NAPH members in 2003, presents the financial challenges they faced, describes the clinical and community services they provided, and profiles the patients they served

Annual reports of the selectmen, treasurer, road agents, school board and district treasurer, library trustees, and vital statistics of the town of Webster for the year ending January 31, 1918.

This is an annual report containing vital statistics for a town/city in the state of New Hampshire

Race, Ethnicity, and Language of Patients: Hospital Practices Regarding Collection of Information to Address Disparities in Health Care

2003 Institute of Medicine (IOM) report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, identified strong evidence of disparities in the health care of racial and ethnic minorities not explained by differences in health insurance coverage and income. Among ways to eliminate these inequalities the IOM report recommended enhanced collection of patient race and ethnicity data. National Public Health and Hospital Institute researchers surveyed 500 non-federal acute care hospitals on their collection of patient race, ethnicity and preferred language information to understand data collection practices in the U.S. hospital industry. The researchers also surveyed 64 safety net hospitals — which typically have very diverse patient populations and presumed data collection experience — on their collection and use of patient race, ethnicity and language preference data. Key Findings: Most hospitals collect data about the race, ethnicity and language preference of their patients. Over three-quarters (78.4 percent) collect race information and one-half collect data on patient ethnicity (50.4 percent) and language preference (50.2 percent). Fewer than one in five hospitals use the data to assess and compare care quality, health services utilization, health outcomes or patient satisfaction. The most common barrier to data collection for hospitals that do not collect these data is the sense that the data are not important, with more than half of non-collecting hospitals identifying this as a barrier to collection. All of the surveyed safety net hospitals routinely collect race and ethnicity data, although only 20 percent have formal data collection policies. Eighty-four percent of these hospitals have a required field for race in their automated registration system and 28 percent have a field for ethnicity that is generally optional. While 80 percent have a field for language it is rarely required and its recording varies widely

Race, Ethnicity, and Language of Patients: Hospital Practices Regarding Collection of Information to Address Disparities in Health Care

2003 Institute of Medicine (IOM) report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, identified strong evidence of disparities in the health care of racial and ethnic minorities not explained by differences in health insurance coverage and income. Among ways to eliminate these inequalities the IOM report recommended enhanced collection of patient race and ethnicity data. National Public Health and Hospital Institute researchers surveyed 500 non-federal acute care hospitals on their collection of patient race, ethnicity and preferred language information to understand data collection practices in the U.S. hospital industry. The researchers also surveyed 64 safety net hospitals — which typically have very diverse patient populations and presumed data collection experience — on their collection and use of patient race, ethnicity and language preference data. Key Findings: Most hospitals collect data about the race, ethnicity and language preference of their patients. Over three-quarters (78.4 percent) collect race information and one-half collect data on patient ethnicity (50.4 percent) and language preference (50.2 percent). Fewer than one in five hospitals use the data to assess and compare care quality, health services utilization, health outcomes or patient satisfaction. The most common barrier to data collection for hospitals that do not collect these data is the sense that the data are not important, with more than half of non-collecting hospitals identifying this as a barrier to collection. All of the surveyed safety net hospitals routinely collect race and ethnicity data, although only 20 percent have formal data collection policies. Eighty-four percent of these hospitals have a required field for race in their automated registration system and 28 percent have a field for ethnicity that is generally optional. While 80 percent have a field for language it is rarely required and its recording varies widely

Spartan Daily, October 14, 1963

Volume 51, Issue 19https://scholarworks.sjsu.edu/spartandaily/4492/thumbnail.jp

Cartels by Another Name: Should Licensed Occupations Face Antitrust Scrutiny?

It has been over a hundred years since George Bernard Shaw wrote that “[a]ll professions are a conspiracy against the laity.” Since then, the number of occupations and the percentage of workers subject to occupational licensing have exploded; nearly one-third of the U.S. workforce is now licensed, up from five percent in the 1950s. Through occupational licensing boards, states endow cosmetologists, veterinary doctors, medical doctors, and florists with the authority to decide who may practice their art. It cannot surprise when licensing boards comprised of competitors regulate in ways designed to raise their profits. The result for consumers is higher prices and less choice, as licensing raises wages by eighteen percent and bars competition from unlicensed workers. For African-style hair braiders, the result is either an illicit business or thousands of hours of irrelevant training imposed by a cosmetology board. For lawyers, the result is less competition from tax accountants, paralegals, and out-of-state lawyers. The Sherman Act’s great accomplishment has been to make cartels per se illegal and relatively scarce—unless the cartel is managed by a professional licensing board. Most jurisdictions consider such boards, as state creations, exempt from antitrust scrutiny by the state action doctrine, leaving would-be competitors and consumers no recourse against their cartel-like activity. We contend that the state action doctrine should not prevent antitrust suits against state licensing boards that are comprised of private competitors deputized to regulate and to outright exclude their own competition, often with the threat of criminal sanction. At most, state action should immunize licensing boards from the per se rule and require plaintiffs to prove their cases under the rule of reason. We argue that the Fourth Circuit’s recent decision, soon to be reviewed by the Supreme Court, to uphold a Federal Trade Commission (FTC) antitrust suit against a licensing board—denying state action immunity to a licensing board and thereby creating a circuit split—was a step in the right direction but did not go far enough. The Supreme Court should take the split as an opportunity to clarify that when competitors hold the reins to their own competition, they must answer to Senator Sherman

Cartels by Another Name: Should Licensed Occupations Face Antitrust Scrutiny?

article published in law reviewIt has been over a hundred years since George Bernard Shaw wrote that “[a]ll professions are a conspiracy against the laity.” Since then, the number of occupations and the percentage of workers subject to occupational licensing have exploded; nearly one-third of the U.S. workforce is now licensed, up from five percent in the 1950s. Through occupational licensing boards, states endow cosmetologists, veterinary doctors, medical doctors, and florists with the authority to decide who may practice their art. It cannot surprise when licensing boards comprised of competitors regulate in ways designed to raise their profits. The result for consumers is higher prices and less choice, as licensing raises wages by eighteen percent and bars competition from unlicensed workers. For African-style hair braiders, the result is either an illicit business or thousands of hours of irrelevant training imposed by a cosmetology board. For lawyers, the result is less competition from tax accountants, paralegals, and out-of-state lawyers. The Sherman Act’s great accomplishment has been to make cartels per se illegal and relatively scarce—unless the cartel is managed by a professional licensing board. Most jurisdictions consider such boards, as state creations, exempt from antitrust scrutiny by the state action doctrine, leaving would-be competitors and consumers no recourse against their cartel-like activity. We contend that the state action doctrine should not prevent antitrust suits against state licensing boards that are comprised of private competitors deputized to regulate and to outright exclude their own competition, often with the threat of criminal sanction. At most, state action should immunize licensing boards from the per se rule and require plaintiffs to prove their cases under the rule of reason. We argue that the Fourth Circuit’s recent decision, soon to be reviewed by the Supreme Court, to uphold a Federal Trade Commission (FTC) antitrust suit against a licensing board—denying state action immunity to a licensing board and thereby creating a circuit split—was a step in the right direction but did not go far enough. The Supreme Court should take the split as an opportunity to clarify that when competitors hold the reins to their own competition, they must answer to Senator Sherman

Annual report of the selectmen and treasurer of the town of Andover together with the reports of the road agents, school board, and other officers of the town and school district, for the fiscal year ending February 15, 1913, also vital statistics for the year ending Dec. 31, 1912.

This is an annual report containing vital statistics for a town/city in the state of New Hampshire