Heitler G
Am J Law Med. 1982 Fall;8(3):251-70.
This article surveys major antitrust issues affecting the health care field with particular emphasis on third party insurers. It deals with the most recent decisions of the United States Supreme Court, including Maricopa, Pireno and McCready, involving limitations on the scope of the antitrust exemptions, and the bearing of these decisions on third party insurers, provider agreements, peer review mechanisms, physician control or sponsorship of prepayment plans, joint insurer activities, relative value fee schedules, maximum fee schedules, and area-wide planning. The article challenges the desirability of strict application of antitrust principles to these and other activities within the health care field, stressing that practices with procompetitive and cost containment aspects should be encouraged and analyzed under the rule of reason rather than a per se approach.
本文概述了影响医疗保健领域的主要反垄断问题,尤其着重探讨了第三方保险公司。它涉及美国最高法院的最新判决,包括马里科帕案、皮雷诺案和麦克里迪案,这些判决涉及对反垄断豁免范围的限制,以及这些判决对第三方保险公司、供应商协议、同行评审机制、医生对预付计划的控制或赞助、联合保险公司活动、相对价值费用表、最高费用表和区域规划的影响。本文对在医疗保健领域对这些及其他活动严格适用反垄断原则的可取性提出质疑,强调应鼓励具有促进竞争和成本控制方面的做法,并根据合理原则而非本身违法原则进行分析。