Antitrust laws are designed to prevent restraints on trade that harm consumers and less powerful competitors. They are especially important as the health insurance market becomes exceedingly concentrated and the health care industry experiences further consolidation. As a result, physicians are frequently placed in positions of diminished bargaining strength, and health plans can impose unilateral, non-negotiable contracts.
Fortunately, health insurers are now required to follow free-market rules that they have been unfairly exempt from for decades. The recently enacted Competitive Health Insurance Reform Act repeals the McCarren Ferguson Act of 1945 which allowed insurers to act as a monopoly setting rates and maximizing profits. The AAOS, along with other industry partners, worked tirelessly to pass this much needed reform.
The AAOS believes that equitable negotiations between physicians and health insurance plans must be allowed to ensure access to quality care. Allowing physicians to negotiate with dominant insurers on a level playing field ensures heightened quality standards for patient care, removes administrative barriers, and allows physicians to engage in care coordination endeavors without fear of antitrust prosecution.