Antitrust reform: Physicians need the right to negotiate

With the FTC and the Justice Dept. reiterating their stance against joint negotiation with health plans, it's more important than ever for Congress to pass antitrust relief for physicians.

Editorial. Sept. 6, 2004.

Two key federal agencies cite the need for more competition in the health care market as a reason why they, again, are refusing to allow physicians to negotiate collectively with health plans. And yet these agencies, again, are failing to recognize the long-term impact health insurance company mergers would have on patients and physicians.

The Federal Trade Commission and the Dept. of Justice on July 23 released a 300-page report saying, again, that collective bargaining by independent physicians would have a negative impact on health care competition. This comes after 27 days of testimony in 2002 and 2003.

The AMA was among those testifying about why antitrust relief is necessary. A big reason why: health plans continue to get larger and larger, giving physicians less and less leverage to negotiate contracts. The plans not only dictate reimbursement, but also unilaterally define medical necessity and other coverage issues that would affect patients. So despite the FTC and Dept. of Justice report, the AMA remains committed to bringing antitrust relief to all physicians.

The FTC and Justice Dept. report restates their past position that physicians may not negotiate collectively with plans unless they are employed, or they work in a handful of states that have passed physician collective bargaining laws. Instead, the report recommends that insurers and the government find payment methods that encourage physicians to lower costs, improve quality and innovate. Perhaps if groups that integrated clinically found ways to meet those goals, rather than focus on prices, the FTC and Justice Dept. say they may look kindly on collective negotiation.