Now that 1994 has evolved into the year of the healthcare merger, regulators should be prepared for an all-out assault in 1995 on antitrust barriers-real and imagined.
Representatives of hospitals and physician groups have long claimed that providers need relief from antitrust laws in order to form integrated networks required in a managed-care environment. Now the American Medical Association has unleashed a full-scale onslaught on current government policy by developing a legislative proposal to grant doctors unprecedented relief from state and federal regulations covering antitrust, fraud and abuse, kickbacks and self-referrals. The scope of the effort is breathtaking, and the AMA has yet to find a legislative sponsor for its scheme.
Given the no-holds-barred battle to create and control integrated healthcare networks, state and federal regulators need a high-level powwow to devise strategies to protect consumers while recognizing the need to eliminate or reduce discrepancies in antitrust enforcement. The Justice Department, for example, has developed a reputation for being less aggressive in merger investigations than the Federal Trade Commission. And providers point to different treatment based on ownership.
In Utah, for example, officials are waking up to the fact that not-for-profits and investor-owned providers aren't so different, and that competition comes in many forms. While the attorney general there is determining his position on Columbia/HCA Healthcare Corp.'s acquisition of Healthtrust, Gov. Mike Leavitt is suggesting it might be good for the state's consumers. This makes one wonder where officials were when Salt Lake City-based Intermountain Health Care was sewing up about 36% of the state's market share and 50% of Salt Lake City's.
Regulators won't be taken in by wild schemes to unfetter hospitals and physicians. If current restrictions were that harsh, scores of mergers would not have occurred this year. Executives must help frame an antitrust policy that serves the future structure of America's healthcare system by providing latitude for market forces and ensuring consumer protection.