SEP-14(2)

In this issue:

Obama Care has brought a classic cost-benefit question in health care to the forefront: How to improve health care while controlling costs? We present a number of analyses, first looking at whether increased insurance coverage compensates for potential losses. Then we discuss several ways a more classic antitrust conflict—preserving competition vs. encouraging efficiency—is playing out. Our articles analyze possible changes in the traditional ways to pay for health care, discuss a denied merger despite acknowledging the combination would improve health care quality, and debate possible additional regulations and even price controls. And we note the conflict is not just between government and private entities—but also between different federal government agencies, and state and federal authorities. Resolution looks to be very tough.

 

Cost-Benefit Analyses for Health Care

Rosa Abrantes-Metz, Albert Metz, Sep 30, 2014

Health Care Benefits vs. Costs: Are We Making the Right Choices?

In fact the two goals—reducing health care costs and increasing insurance coverage—are generally incompatible. Rosa Abrantes-Metz (Global Economics Group) & Albert Metz (Moody’s).

Kent Bernard, Sep 30, 2014

Patient Outcomes vs. Competition: Squaring the Circle in FTC v. St. Lukes

The way that we as a society pay for health care serves to reinforce the traditional antitrust approach, but if the changes envisioned by the health care reform laws actually come to pass, antitrust may have to make a major adjustment. Kent Bernard (Fordham)

Kenneth Field, Sep 30, 2014

Redefining Care and Competition Models in Health Care

Focusing on the narrow efficiencies defense ignores potential common ground that deserves further development and discussion. Ken Field (Jones Day)

Helen Kim, Dionne Lomax, Sep 30, 2014

The Evolution of Efficiencies and Treatment of Quality of Care Defenses in Light of Changing Health Care Industry Dynamics

It is clear that the FTC is skeptical of a hospital merger’s ability to reduce costs and improve quality. Dionne Lomax & Helen Kim (Mintz, Levin)

Andrew Mann, George Paul, Sep 30, 2014

Is the Affordable Care Act the Catalyst to Merger Efficiency Reform?

The healthcare industry is teed up to provide enough data points to really move the needle in terms of analyzing out-of-market efficiencies—and any developments in this arena will have implications outside the healthcare context. George L. Paul & Andrew K. Mann (White & Case)

J. Mark Waxman, Sep 30, 2014

Integrating to Enhance Value and Quality vs. Preserving Competition to Maintain Lower Prices

Unfortunately, there is no bright line to indicate where the balance lies between the desire for efficiency and population health management and the need to retain a competitive environment as a check on pricing decisions. J. Mark Waxman (Foley & Lardner)

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