Transcript Antitrust

Antitrust
Fundamental Assumptions
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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
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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
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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
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Vertical markets
Horizontal markets
What is the market for services?
 Rural markets with limited providers
 Urban markets
Are there specialized services?
Monopoly Power
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What does monopoly power allow?
 Unilateral anticompetitive actions
Tying
Retail price maintenance agreements
 Before the court right now
Joint Action
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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
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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
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Group boycott
 Wilk - Chiropractor
 Indiana Federation of Dentists
Market division agreements
Price fixing
The Advertising Cases
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Lawyer advertising
 First case was advertising lower prices
 Then any truthful advertising
Physicians
 Followed the lawyer cases
Physician Staff Privileges Cases
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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?
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What can large group practices do that individual
docs cannot do?
How about hospitals buying practices?
 How does this affect competition?