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Recent supreme court antitrust rulings in health care.

Three recent U.S. Supreme Court antitrust rulings that influence the health-care delivery system are examined. Historically four defenses protected the health-care system from antitrust law. They are the learned-profession exemption, the fact that health-care systems have little effect on interstate commerce, the state-action defense, and the business-of-insurance exemption under the McCarran-Ferguson Act. These defenses and Supreme Court cases that have weakened or eliminated them are described. The cases are Arizona v. Maricopa County Medical Society, Union Labor Life Insurance Co. v. Pireno, and Blue Shield of Virginia v. McCready. Health-care providers will be subject to increased antitrust scrutiny as a result of these cases.

Arizona↗

Labor pains.

Unions have targeted health care for their next surge of organizing and political action. They have lots of money and, they believe, the health consumer on their side.

Collective Bargaining↗

Human immunodeficiency virus/acquired immunodeficiency syndrome training from a union perspective.

The authors developed a union sponsored 2-day human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) "train the trainer" program for healthcare workers in the San Francisco Bay Area. The program incorporated the "education for action" approach in an effort to respond to the inadequacies in many traditional, institutional trainings. Service Employees International Union (SEIU) and Labor Occupational Health Program (LOHP) conducted the HIV/AIDS "train the trainer" program for approximately 100 healthcare workers in county public hospitals and community health clinics. After completing the program, these workers went back to their healthcare facilities, or community organizations, and led additional classes on HIV/AIDS transmission and prevention for approximately 600 more people. The goal of the program was to empower healthcare workers to: 1) identify the occupational risks associated with exposure to blood and potentially infectious body fluids at the workplace; 2) develop strategies to reduce those risks; 3) discuss their feelings about caring for an HIV/AIDS patient; and, 4) conduct HIV/AIDS workshops at the workplace.

Acquired Immunodeficiency Syndrome↗

Industrial democracy. The Victorian health sector experience.

There is growing evidence to suggest that the principles of industrial democracy have been adopted by two of the major players in the delivery of health care, namely, the unions and the Labor Government. The opportunity now exists for health service administrators to manage participatively the introduction of this relatively new concept. For this participation to be effective there must be an improvement in the current level of understanding by health service managers of employee participation techniques and initiatives.

Australia↗