Health care injustice

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Regarding the Jan. 2 letter “Insurance Conflicts”: Don Grbac of Valencia sums it up when he said, “I cannot imagine a more profound conflict of interest than a hospital system creating its own insurance program.” It is amazing to me that such arrangements ever passed the scrutiny of the U.S. Justice Department.

According to Wikipedia, competition, or antitrust, law has three main elements:

1. Prohibiting agreements or practices that restrict free trading and competition between businesses. This includes in particular the repression of free trade caused by cartels.

2. Banning abusive behavior by a firm dominating a market, or anti-competitive practices that tend to lead to such a dominant position. Practices controlled in this way may include predatory pricing, tying, price gouging, refusal to deal and many others.

3. Supervising the mergers and acquisitions of large corporations, including some joint ventures.

Maybe UPMC health insurance should send its clients only to the Allegheny Health Network and Highmark Blue Cross Blue Shield should send its clients only to UPMC hospitals to avoid the appearance of a conflict of interest (antitrust-wise)?

These local hospital/​insurance arrangements began long before David J. Hickton became the U.S. attorney for Western Pennsylvania, but you still got to wonder: Who is watching the store?


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