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Full-Text Articles in Law
Competition Policy And Organizational Fragmentation In Health Care, Thomas L. Greaney
Competition Policy And Organizational Fragmentation In Health Care, Thomas L. Greaney
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A central challenge for all health care reform proposals currently being discussed is finding the means to effectively channel market forces given many deeply embedded features of our system and the peculiar economics of health care delivery and financing. This essay traces the path of competition law in health care and explains its chicken-and-egg relationship with provider organizational arrangements. It explores a central puzzle for future health care policy: why have market forces failed to counteract organizational fragmentation? Answering this question requires an understanding of why competition policy is inexorably linked to the organizational structures of health care providers and …
Antitrust & Hospital Mergers: Does The Nonprofit Form Affect Competitive Substance?, Thomas L. Greaney
Antitrust & Hospital Mergers: Does The Nonprofit Form Affect Competitive Substance?, Thomas L. Greaney
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Following a string of government losses in cases challenging hospital mergers in federal court, the Federal Trade Commission and the Department of Justice issued their report on competition in health care seeking to set the record straight on a number of issues that underlie the judiciary's resolution of these cases. One such issue is the import of nonprofit status for applying antitrust law. This essay describes antitrust's role in addressing the consolidation in the hospital sector and the subtle influence that the social function of the nonprofit hospital has had in merger litigation. Noting that the political and social context …
Mission, Margin, And Trust In The Nonprofit Health Care Enterprise, Thomas L. Greaney, Kathleen Boozang
Mission, Margin, And Trust In The Nonprofit Health Care Enterprise, Thomas L. Greaney, Kathleen Boozang
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The law governing charitable corporations remains neglected and thoroughly muddled. Still unsettled are central issues regarding the accountability of directors and management, legal standards governing organic changes by nonprofit institutions, and mechanisms to ensure fidelity to the organization's charitable mission. For nonprofit corporations in the health care sector, which represent a large proportion of all health services supplied nationwide, particularly charity care, these shortcomings have had serious repercussions. The central issue addressed in this Article is how fidelity to the mission of the charitable health care corporation should be monitored. It advances the normative perspective that the law should maximize …
Night Landings On An Aircraft Carrier: Hospital Mergers And Antitrust Law, Thomas L. Greaney
Night Landings On An Aircraft Carrier: Hospital Mergers And Antitrust Law, Thomas L. Greaney
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Abstract: Analysis of the competitive effects of hospital mergers requires antitrust tribunals to make exceedingly fine-tuned appraisals of complex economic relationships. The law requires fact finding in a number of complex areas, e.g., defining product and geographic markets, predicting the possibility of that firms will engage in coordinated behavior; and assessing efficiencies flowing from the merger. Further complicating the process is the fact that these decisions require judgments regarding what the future may hold in an industry undergoing revolutionary change. Like pilots landing at night aboard an aircraft carrier, courts are aiming for a target that is small, shifting and …
Competitive Reform In Health Care: The Vulnerable Revolution, Thomas L. Greaney
Competitive Reform In Health Care: The Vulnerable Revolution, Thomas L. Greaney
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This article, written at the dawn of the era of "competitive reform" in health care examines the case and prospects for the introduction of competition in health care delivery and financing. It observes the failures of the ancienne regime of fee for service payment and professional sovereignty and discusses the benefits of market-oriented policy. Its contribution, still salient today, is the lesson that competition cannot succeed without regulation. It identifies legislative, professional, and cultural hurdles to effective implementation of competitive norms and policies that have impeded the success of competition policy in health care.