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《克莱顿法案》对患者的保护

The Protection of Patients Under the Clayton Act.

作者信息

Kraus Elizabeth S

出版信息

Fordham Law Rev. 2018 Apr;86(5):2473-509.

PMID:29993208
Abstract

The vast consolidation among health-care providers in the aftermath of the Affordable Care Act's enactment has led to much debate over the benefits of mergers in the health-care industry. In 2016, the Federal Trade Commission filed motions in federal court to enjoin three hospital mergers in various parts of the country. This amounted to more challenges to hospital mergers in a single year than any year in recent history. Though two of these motions succeeded at the district court level, both were overturned on appeal, which led many to wonder what the effect of these decisions would be on future health-care mergers. While many fear that hospital mergers lead to higher prices for consumers, there are also those who contend that mergers lead to efficiencies, which allow merging parties to utilize resources more effectively, increase the quality of patient care and coordination, and potentially save lives. This Note argues that the possibility of quality-enhancing or life-saving efficiencies is worth the risk that consumers see increased prices. To allow mergers that may realize these types of efficiencies, antitrust enforcement agencies and courts must begin placing greater weight on merging parties' efficiency arguments by easing the current standard. Additionally, in light of new research suggesting that cross-market health-care mergers, or mergers between providers in different geographic markets, affect bargaining dynamics between providers and insurers, this Note argues that parties' relative bargaining power must be considered in agencies' and courts' analyses of the competitive landscape relevant to a merger.

摘要

《平价医疗法案》颁布后,医疗保健供应商之间大规模的合并引发了对医疗行业合并益处的诸多争论。2016年,联邦贸易委员会向联邦法院提出动议,要求禁止在该国不同地区进行的三起医院合并。这意味着一年内对医院合并的质疑比近代历史上任何一年都要多。尽管其中两项动议在地区法院层面获得成功,但在上诉时均被推翻,这让许多人不禁思考这些判决对未来医疗保健合并会产生什么影响。虽然许多人担心医院合并会导致消费者面临更高的价格,但也有人认为合并会带来效率提升,使合并各方能够更有效地利用资源,提高患者护理和协调质量,并有可能挽救生命。本论文认为,提高质量或挽救生命的效率可能性值得冒消费者看到价格上涨的风险。为了允许可能实现这类效率的合并,反垄断执法机构和法院必须通过放宽现行标准,开始更加重视合并各方的效率论点。此外,鉴于新的研究表明跨市场医疗保健合并,即不同地理市场的供应商之间的合并,会影响供应商与保险公司之间的谈判动态,本论文认为在机构和法院对与合并相关的竞争格局分析中,必须考虑各方的相对议价能力。

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