If there is no evidence that a hospital is using market power to "force" its contracting physician upon patients and if the exclusive contract does not adversely affect price or quality, an exclusive arrangement should not violate the federal antitrust laws. These are the insights gained from the decision handed down by the Supreme Court in Hyde (Jefferson Parish Hospital District No. 2 v. Hyde, No. 82-1031).
Economics, patient characteristics, health status, and "objective" measures have served as rationing agents for diminishing health care resources. The big question, however, is whether the lessons of past restrictions on health care can be applied today- and should they?
How to deal with terminally ill incompetent patients is a painful dilemma for for hospital medical staffs and administrators, not to mention families of these patients. Case law on the removal of life support is emerging, and physicians and administrators may find the hospital-based ethics committee one means to guide them in making difficult decisions without involving the courts.
In response to continuing increases in health care costs, big business has begun to lower the boom on hospitals and physicians through outside utilization review. Physicians, however, are seen as the key to controlling costs.
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