The "Quality Health Care Coalition Act": Can antitrust law improve patient care?

Last June, the U.S House of Representatives voted in favor of H.R. 1304, the "Quality Health-Cave Coalition Act," by move than a 2-1 margin. The bill, introduced by Rep. Tom Campbell, would allow doctors and other health care professionals to engage in collective bargaining with HMOs - a practice that would otherwise violate existing antitrust laws. Supporters argue that this measure will "level the playing field" between doctors and HMOs and will allow doctors to bargain for medical policies that will improve patient care Opponents counter that the Campbell Bill will raise health care costs without producing higher quality medical services. The Senate did not vote on the Campbell Bill during the 2000 session, but it may consider the bill during the coming year. This note begins by reviewing the criticisms of HMOs that led to the introduction of H.R. 1304 and other proposed reforms. It then summarizes the relevant antitrust laws and labor laws that form the background to this controversy. Finally, it analyzes the Campbell Bill and considers the possible effects that H.R. 1304 would have on the American health care system if it were to become law. This note concludes that H.R. 1304 would increase health cave costs without necessarily improving patient care and that new exceptions to the antitrust laws are not warranted by existing market conditions in the health care sector. Instead of enacting H.R. 1304, this note recommends active enforcement of existing antitrust laws.