Antitrust

Fundamental Assumptions Competition is good Big is not bad Monopoly practices are bad People should be allowed to buy whatever quality they want The market will provide whatever is necessary

Penalties Federal prosecution Criminal fines Prison time Civil enforcement by the FTC Fines Treble Damages Private enforcement Treble damages and attorney's fees

Per Se v. Rule of Reason Violations Per se violations only require proof of the violation, not the market power of the competitors or the effectiveness of the action Rule of reason violations require detailed market analysis The defendant is well on the way to winning if the court decides it is rule of reason

Market Organization Vertical markets Horizontal markets What is the market for services? Rural markets with limited providers Urban markets Are there specialized services?

Monopoly Power What does monopoly power allow? Unilateral anticompetitive actions Tying Retail price maintenance agreements Before the court right now

Joint Action Any time competitors make agreements that affect competition there is an antitrust question Professional standards can be anti-competitive vehicles Why are docs such a problem? Are labor unions an alternative?

The Professional Standards Defense Is it a defense that the restraints improve patient care? Why does the FTC not care about quality? What are other controls on quality? Can you do group action through the professional organization? Is JCAHO an illegal conspiracy?

Per Se Violations Through Joint Action Group boycott Wilk - Chiropractor Indiana Federation of Dentists Market division agreements Price fixing

The Advertising Cases Lawyer advertising First case was advertising lower prices Then any truthful advertising Physicians Followed the lawyer cases

Physician Staff Privileges Cases How can staff privileges become an antitrust issue? Is peer review among competitors always an antitrust issue? How could the staff avoid this claim? What did the feds do to protect peer review?

How do Antitrust Issues Change with Health Care Consolidation? What can large group practices do that individual docs cannot do? How about hospitals buying practices? How does this affect competition?