Obamacare's Hospital Monopolies

Obamacare induces significant consolidation among providers, which the Federal Trade Commissioner has long recognized can be anti-competitive. State antitrust overseers are also pushing back against this effect.

Read more at NCPA's Health Policy Blog.

This Photo Tells You What You Need To Know About Obamacare's Perverse Incentives

One theme of NCPA’s Health Policy Blog is that health insurers in Obamacare’s exchange plans have perverse incentives to attract healthy patients and deter sick ones from enrolling.

If this photo does not tell us that insurers want healthy people to apply, I don’t know what will.

Read the entire column at NCPA's Health Policy Blog.

The U.S. Government Will Like the Express Scripts-Medco Takeover

Medco traded at a ten percent discount to the deal terms all day Thursday, reflecting skepticism that the U.S. government will let the deal happen. I don't see why. The government favors concentration in the health sector.

Read my latest column at Forbes.com: The Apothecary.

Antitrust: The U.S. Vs. Michigan Blue Cross Blue Shield

Today's news of the overreaching federal state brings reports of antitrust action by the US Department of Justice against Blue Cross and Blue Shield of Michigan.  The purported violation? As Michigan's largest health plan, BCBS was able to persuade hospitals not to charge lower fees to any other carrier.  According to the story, other health plans paid hospitals 25 percent more than BCBS.

Orthopedic Surgeons Vs. Insurers in Idaho

The U.S. Department of Justice has settled antitrust allegations against a small group of orthopedic surgeons in Idaho. I suggest that the federal antitrust jurisdiction is inappropriate, at StateHouseCall.

Beyond ObamaCare: The 9th & 10th Amendments and The "Right to Health Care"

This month's Health Policy Prescription.

Subjecting Health Insurers to Federal Antitrust?

Subjecting health insurers to federal antitrust laws would achieve nothing: My latest Health Policy Prescription.

Graham on ABC News on Health Reform

ABC News investigated the health-care "industry"'s promise to President Obama that they would collaborate on long-term cost-savings. This time, they really, really mean it!

I made some critical remarks. Of course, they only took the first part of my statement, the criticism, and edited out the second, which contained a proposal. But thems the breaks. Here are my full comments:

“If the interest groups in any other American industry colluded on a plan to control costs, they’d be charged under the anti-trust laws. Only in health care do Americans persist in believing that Soviet-style central planning can increase quality and reduce costs. We’ve been trying this since the 1980s, when the Reagan administration completely out of character) announced that Medicare would start fixing prices. But the massive increase in government control and spending for almost half a century since Medicare and Medicaid were imposed on taxpayers have resulted in out of control costs, uncertain quality, and the warning signs of rationed access to care in the near future. The American people should not tolerate health-care interest groups collaborating with the government to form the mother of all cartels, rationing our health care to adhere to a federal budget. Only 16 cents of every dollar spend on U.S. health care is controlled by patients. The rest is controlled by government and health insurers. The key to ensuring value for money lies in returning a bigger share of the dollar to individual Americans.”

Class-Action Lawsuits Gone Wild

By itself, this isn't such a big deal: A non-profit hospital system in upstate New York settles a class-action lawsuit brought by a couple of nurses for $1.25 million. Plaintiffs alleged that the hospitals conspired to artificially lower nurses' wages.

The Wall Street Journal reports that the settlement will be filed today at the U.S. District Court for the Northern District of New York. Another paper reports that the suit was duplicated in Detroit, Chicago, Memphis, & San Antonio.

I have previously written, in a related context, that federal anti-trust law should not apply to contracts between hospitals and health professionals. I think that this case confirms the flaw.

Generally speaking, I think anti-trust law is nonsensical. However, if it must exist, state anti-trust law should suffice in these cases. Hospitals and health professions are regulated by the states, so states' laws should respond to the consequences of that power. There is no reason to believe that federal anti-trust laws are superior, especially when these cases do not bleed across state lines.

On the other hand, the scope for lawyers' mischief-making is high. What benefit would it be to a hospital in Albany, NY, to conspire with hospitals in Memphis or Detroit to fix nurses' wages? Very little, surely, given that the conditions of work and cost of living, and even scope of practice of the profession, varies across regions.

On the other hand, what a jackpot for the lawyers if they can lead nurses nationwide on a fishing expedition! This appears to be the case, as Northeast Health has agreed to spill the beans on other hospitals, too.