It is an astounding number, but health care expenditures in the United States now account for approximately $2.5 trillion, or approximately 17 percent of our gross domestic product, and are projected to rise to 20 percent in coming years. Congress and the Obama administration are struggling with ways to control Medicare and Medicaid expenditures, and health care costs in general. Most experts agree that vigorous competition—even in a sector that is awash in government money and federal and state regulations—is a critical factor in reining in these escalating costs.
Many hospitals—both for-profit and not-for-profit—have been consolidating into regional systems. Their rationale has been that such consolidations can bring about cost efficiencies, increased access to medical services for their communities, improved quality of care, and lower prices. Until recently, there have been relatively few antitrust challenges to hospital mergers. For a time in the late 1990s the federal government’s challenges to hospital mergers were largely unsuccessful.1 But things have changed, and hospitals should take careful note of some important recent cases where mergers have been challenged.
Enforcement
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