Rural Health Care and State Antitrust Reform

42 Pages Posted: 13 Feb 2015

See all articles by Michael S. Jacobs

Michael S. Jacobs

DePaul University - College of Law

Date Written: 1996


Two premises underlie state health care antitrust law reform measures. The first presumes that the federal antitrust laws prevent efficiency-enhancing collaborations and that, by displacing the federal regime, states can encourage health care firms to generate cost savings that they in turn will pass on to consumers. The second presumes that rural markets in particular will benefit from the continued presence of their "traditional" health care providers now threatened with extinction and that provider cooperation laws will resuscitate firms that would otherwise perish.

These are laudable goals, but they are ill conceived and mutually inconsistent. As I shall argue in the following pages, these new laws are unresponsive to the major problems of rural communities, unnecessary to facilitate provider cooperation, and administratively unworkable. They benefit existing, inefficient providers and work against the emergence of new forms of health care. They threaten to harm consumers, especially "marginal" ones. Moreover, the appearance of these laws coincides with two developments that seem to make antitrust reform superfluous. Since 1993, federal agencies have gone to extraordinary lengths to spell out their enforcement policies in the health care field and to assure health care providers that the large majority of their collaborative efforts will pass unchallenged. At the same time, federal courts have substantially changed their view of health care markets, effectively making it much more difficult for enforcement agencies to bring successful challenges to mergers and joint ventures.

Suggested Citation

Jacobs, Michael S., Rural Health Care and State Antitrust Reform (1996). Mercer Law Review Vol. 47, No. 4, 1996, Available at SSRN:

Michael S. Jacobs (Contact Author)

DePaul University - College of Law ( email )

25 E. Jackson Blvd.
Chicago, IL 60604-2287
United States

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