Physician price fixing under the Sherman Act. An indirect test of the Maricopa issues.

The expression 'price fixing' usually indicates an attempt by competitors to put a floor under the minimum price they will charge. But a recent decision of the Supreme Court, Arizona v. Maricopa County, suggests that attempts to fix maximum prices are equally economically objectionable. In this paper I propose an explanation of simultaneous minimum and maximum price fixing. I also investigate empirically the distribution of physicians' fees in a closely related instance of alleged physician price fixing. The data reject any inference of successful price fixing, and instead conform to the usual predictions of the economics of costly market information.

Risky business: how insurance companies gamble with your health coverage.

Under a patchwork of state laws and virtually no federal oversight, a decade of risky investments, questionable business dealings, lavish spending, and help-yourself ethics in the insurance industry is playing a hidden role in the crisis in affordable medical coverage. Skyrocketing medical costs are the main culprit, but financial losses have put pressure on insurers to raise premiums and cancel risky policyholders. The losses also are a major factor in the sharp increase in life/health insurance company failures, which can leave policyholders stranded.

Vertical restraints among hospitals, physicians and health insurers that raise rivals' costs. A case study of Reazin v. Blue Cross and Blue Shield of Kansas, Inc. and Ocean State Physicians Health Plan, Inc. v. Blue Cross and Blue Shield of Rhode Island.

Two recent district court opinions consider whether affiliations among hospitals, doctors and health insurers--through contract or ownership--violate the antitrust laws. This Article applies a raising rivals' costs framework to the facts of those cases in order to assess whether the practices at issue were unreasonable.

ERISA preemption. St. Francis Medical Center v. Blue Cross and Blue Shield of Kansas, Inc.

ERISA preempts hospital's state law action challenging insurer's rule banning health plan participants from assigning their benefit claims to health care providers who had not signed contracts with insurer.