PubMed · 1559685
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J Johnsson. 1992-04-20. Collaboration grows despite antitrust rules.. https://pubmed.ncbi.nlm.nih.gov/1559685/
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Since 1989 a gradual restructuring of the Dutch health care system is taking place to realize a multiple choice social health insurance system with workable competition among insurers and among health care providers. This paper investigates whether the structural change will induce the intended competition. An examination of the characteristics of the market for health insurance, physician services and hospital services in the Netherlands points out that the scope for competition is limited. If competition is to work, rather extensive government regulation to monitor the conduct of both providers and insurers is needed. Without an effective antitrust policy a high degree of concentration and collusion is likely.
Patrick v. Burget, the landmark peer review case holding physicians liable under federal antitrust law for substantial damages caused by bad faith peer review, gave rise to the Health Care Quality Improvement Act. As shown in the recent decision in Austin v. McNamara, the Act's conditional immunities may promote peer review. However, the Act also created the National Practitioner Data Bank, which may have a chilling effect on peer review. The quality assurance implications of each of these federal legal developments is analyzed.
Due to existing internal forces, a movement toward vertically integrated regional health systems is imperative in order to ensure the future viability of our health care system. However, in order for these systems to be successful, they must first overcome several imposing barriers.