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.