The probable effects of Federal Trade Commission actions on dentistry and dental education

For the last several years the Federal Trade Commission has been actively involved in investigation and legal action within the market for dental services. The essence of FTC policy has been to promote competitive market forces in the dental care sector. This intervention has produced and will continue to produce several direct and indirect effects on dental education. By shaping the rules of the game for the dental services market and by influencing the income prospects for dental practice, the FTC's forays will alter the type of training and knowledge demanded by dental school applicants, the quality of the applicant pool, the mix of practice settings selected by newly graduated practitioners, the nature of school-based clinical practice, and the process and content of the dental school curriculum.

Antitrust and third party insurers

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.

Antitrust law and collective physician negotiations with third parties: the relative value guide object lesson

This article examines the role of collective physician participation in the third-party reimbursement system. It critiques the Havighurst-Kissam analysis of the antitrust implications of professionally-developed relative value guides and, using lessons derived from the only litigated case on relative value guides, argues that collective physician input into third-party reimbursement plans can be made in a manner which is consistent with the antitrust law as and cost-containment policy objectives. In particular, collective "negotiations" by organized physicians with third parties, unaccompanied by fee agreements among physicians or by actual or threatened physician boycotts, are found to be procompetitive and hence permissible under the rule of reason.

Antitrust and health care: provider controlled health plans and the Maricopa decision

The health care industry is one which traditionally has discouraged its members from engaging in competition. For years, many within the profession have espoused a guild mentality and have viewed professional societies as the proper centers of health care's economic universe. This guild mentality has recently been challenged by proponents of a market mentality, theoreticians who argue that limited combinations of health care providers called "health plans," which serve insurance as well as service functions, can make the health care industry more efficient. Proponents of the guild mentality have been dealt a severe blow by the Supreme Court and its decision in Arizona v. Maricopa County Medical Society. There the Court found the price-fixing by two Arizona medical societies to be illegal per se under applicable antitrust law. This Article outlines the background on competition and the guild mentality in the health care industry. After a brief discussion of the standards of antitrust analysis, the Article analyzes the Maricopa case, by first summarizing the Court's use of strict antitrust criteria, and then by extending the analysis to an application of a more lenient standard. Next, the Article compares the provider controlled independent practice association ("IPA")--one form of insurance plan proposed by market model advocates--with the Maricopa-type plan. Finally, the Article concludes that, not only is the special form of IPA that qualifies as a "health plan" an excellent way to promote efficiency in the health care industry, but also its procompetitive goals and effect allow it to survive even the strictest, Maricopa-type antitrust scrutiny.