Sage W M
Columbia University, USA.
Health Aff (Millwood). 1997 Nov-Dec;16(6):44-61. doi: 10.1377/hlthaff.16.6.44.
The emergence of a competitive market in health care portends an increasingly important role for antitrust law. Managed care is even more difficult than fee-for-service practice to analyze in the quantitative, economic terms required by modern principles of antitrust law. This paper examines a recent court decision authored by a prominent judge and antitrust scholar: Blue Cross and Blue Shield United of Wisconsin v. Marshfield Clinic. The purpose of the paper is not to describe the law as it is or as it should be, but to illustrate the assumptions and gaps in understanding that can occur when courts are asked to evaluate this complex and rapidly changing industry without the benefit of sound empirical research.