Legislature Considers Bill Granting Collective Bargaining Rights to Doctors
Under a bill (AB 1600) "working its way through the state Legislature," doctors and medical groups could be exempted from federal antitrust laws and permitted to collectively bargain with health plans over payments, the San Francisco Chronicle reports. Under current law, physician groups and individual doctors have been "barred" from sharing health plan contract information, but the legislation would lift the ban. The legislation would also require the state Department of Managed Health Care to "certify" doctors as an "approved group" and to authorize the "final rate agreement" between physicians and health plans. Sponsored by Assembly member Fred Keeley (D-Boulder Creek), the bill passed the Assembly on June 6 and will go before the Senate Judiciary Committee on July 10. About 60,000 full-time physicians would be affected in the state, but small medical groups are the "most likely" to take advantage of the proposal, as they currently have less power than larger groups. The California Medical Association is backing the legislation, as it would "offset the imbalance of power" between health plans and doctors that has resulted in "inadequate rates" for physician services. Opponents, however, say the bill will allow specialists to "fix prices." Bobby Pena, a spokesperson for the California Association of Health Plans, said, "What CMA is asking for is the right of collective bargaining and antitrust exemptions without the responsibilities a union would have to do the same thing. Our concern is it's collusion; it allows [doctors] to price fix" (Colliver, San Francisco Chronicle, 7/5).
"[T]urning physicians into the equivalent of union members would only make a bad situation worse," Daniel Weintraub writes in a Sacramento Bee column. Because medical groups are already exempt from antitrust laws, the legislation would "extend that exemption" to doctors who share "no affiliation except that they practice medicine in the same region." Weintraub notes that consumer and business groups are against the bill, because it would "drive up" costs without improving care. Also, the state approval process is a "potential nightmare of regulation," as bureaucrats would be required to determine whether "every fee ... is fair and reasonable." Noting that health plans should be "concerned with financial risk" and physicians with "providing care," Weintraub concludes: "[G]iving doctors the right to fix prices would surely make health care more expensive. It would not necessarily make it any better" (Weintraub, Sacramento Bee, 7/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.