Blogging today from the annual conference of the California Association of Health Plans (CAHP) where I learned something new: physicians are oligopolists. Funny isn't it? I usually hear from doctors that health insurers are the oligopolists!

So, how goes the battle of the oligopolies?

Truth be told, I never really bought the physicians' complaint that anti-trust laws prevent them from combining (a.k.a. unionizing) to negotiate contracts with health insurers. First, they could just organize their own insurers, (which is how Blue Shield started), like the very successful CDPHP (Capital District Physicians' Health Plan) in Albany, NY. Second, they can just quit and work for cash only.  (Something I recommend very seriously, especially to primary-care practitioners.  I doubt that family doctors will ever be treated properly by 3rd party payers.  However, there is an exciting effort, the Patient Centered Primary Care Collaborative, that I hope will prove me wrong.)

Thanks to a recent Federal Trade Commission ruling, the doctors seem to have lost their basis for claiming they cannot organize to negotiate with health plans.  The Greater Rochester Independent Practice Association (GRIPA) has just secured an FTC opinion that its "proposed program would involve substantial integration among its physician participants that has the potential to produce significant efficiencies in the provision of medical services...", and will not recommend anti-trust action.

Now, I don't know why the FTC has to stick its nose into an arrangement that appears to take place entirely within New York state, but so be it.  Will this have impact across the country?  Surely, the several states also have laws and regulations that prevent physicians' freedom of association, but the FTC has nevertheless toppled an important obstacle.  Let's hope physicians' groups nationwide keep up the momentum.

(I had been planning to blog about a Hawaii hospital that launched a price-transparency tool that allows patients to estimate out-of-pocket costs - whatever their insurance status, according the the Pacific Business News.  But I spent over ten minutes at the hospital's website and coudn't find a hint about it.  Am I the only one getting fed up with price-transparency vaporware?)