Doctors and hospitals: an antitrust perspective on traditional relationships

Under new pressures for cost containment, hospitals are increasingly asserting interests that conflict with those of physicians. Professor Havighurst argues that legal rules under which practitioners have challenged denials of hospital admitting privileges should be clarified in order that hospitals can more effectively carry out their new cost-containment and other responsibilities. He invokes antitrust law's "essential-facilities" doctrine to protect those abused by their competitors on a hospital staff, but he contends that, if a hospital participates in decisionmaking as an independent actor--even though it acts in concert with its physicians--, antitrust courts should lower the level of scrutiny to a point at which most challenges can be dismissed summarily. He analogizes restraints imposed by hospitals on competition between health professionals to vertical restraints of other kinds, and draws conclusions critical of doctrine traditionally applicable to the latter.     

Renovating the Commons: Swedish health care reforms in perspective

Recent reform experience in Sweden supports the premise that key dimensions of a country's health care system reflect the core social norms and values held by its citizenry. The fundamental structure of the Swedish health system has remained notably consistent over the past half century, that is, tax-based financing and publicly operated hospitals. Yet on other, nearly as important, parameters, there has been substantial change, for example, the persistent pursuit for thirty years of a stronger primary care framework and the effort to allow patient choice of doctor, health center, and hospital within the publicly operated system. This particular combination of continuity and change has occurred as traditional Swedish values of jamlikhet (equality) and trygghet (security) have been challenged in an environment shaped by an aging population, changing medical technology, and Sweden's integration into the European Single Market. This article explores the ongoing process of health system development in Sweden in the context of the country's broader social and cultural characteristics.     

The politics of management in health care: a British perspective

This paper discusses the contribution of organizational political perspectives to a better appreciation of policy implementation problems in health care. The context is the efforts of successive British governments to accord a higher priority to community health and long-stay services. The limited success of these policies owes much to continuing medical control of the philosophy of the organization and agenda, in spite of government responsibility for funding and providing health services. More effective policy implementation depends on a recognition of the "naturalness" of organizational politics, rather than treating them as constraints in an otherwise rational, managerial system.     

Taking action to contain health care costs: Part 1

Health care is one company expenditure that can definitely be cut and controlled. Part I of this two-part study focuses on what major corporations have been doing to keep their costs down and their employees healthy--practices which will work within most existing corporate structures.     

Draft guideline for infection control in health care personnel, 1997--CDC. Notice

This notice is a request for review of and comment on the Draft Guideline for Infection Control in Health Care Personnel, 1997. The guideline consists of two parts: Part 1. "Infection Control Issues for Health Care Personnel, an Overview" and Part 2. "Recommendations for Prevention of Infections in Health Care Personnel", and was prepared by the Hospital Infection Control Practices Advisory Committee (HICPAC), the National Center for Infectious Diseases (NCID), the National Immunizations Program, and the National Institute of Occupational Safety and Health (NIOSH), CDC.