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Competition Policy and Organizational Fragmentation in Health Care

Thomas L. Greaney

Saint Louis University School of Law

Saint Louis U. Legal Studies Research Paper No. 2009-04

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 payers and how that the fragmentation that bedevils those arrangements has undermined its success. The article concludes with a negative assessment of recent “consumer directed” approaches, finding them likely to increase fragmentation and incapable of delivering the benefits of competition.

Number of Pages in PDF File: 17

Keywords: Health reform, antitrust, hospital mergers, FTC, managed care, health economics, consumer directed health care, fragmentation, HMO, market failure

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Date posted: April 28, 2009  

Suggested Citation

Greaney, Thomas L., Competition Policy and Organizational Fragmentation in Health Care. Saint Louis U. Legal Studies Research Paper No. 2009-04. Available at SSRN: http://ssrn.com/abstract=1395792

Contact Information

Thomas L. Greaney (Contact Author)
Saint Louis University School of Law ( email )
100 N. Tucker Blvd.
St. Louis, MO 63101
United States

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