S.M. Oliva's piece on antitrust actions against physician associations ("Doctors' Orders," December) includes some anecdotes that show it is costly and consuming to fight the Federal Trade Commission. That is no surprise. But I saw no arguments supporting Oliva's statement that enforcement against physicians collectively negotiating health plan contract terms, including payment rates, "will do nothing to reduce rising health care prices, while serving to dampen competition."
As a representative for health plans in physician contract negotiations for nearly two decades, I have worked with dozens of independent physician associations (IPAs). With few exceptions, the primary, if not sole, purpose of the IPA has been to secure terms for the physician members more favorable than those that the physicians could secure independently. The most important of these terms is the reimbursement rate from the health plan. If the benchmark for success is higher fees, the result is certainly increased health care costs to health plans, employers, and patients.
Oliva reports that the FTC and Justice Department have prosecuted 36 IPAs in the last decade. Thirty-six prosecutions out of the thousands of such associations nationally is disturbing for how...