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Physician unionization: a difficult proposition: antitrust laws, other barriers.(Practice Trends)
WASHINGTON -- Interest in physician unionization is increasing as health insurers become more powerful, but doctors who want to unionize still face many barriers, said several speakers at a hearing sponsored by the Federal Trade Commission and the Department of Justice.
Organized medicine is less resistant to the idea of unions than it was a few years ago, said Carl F. Ameringer, Ph.D., associate professor of political science at the University of Wisconsin, Oshkosh. "The American Medical Association has essentially gone into the union business with the formation of [its bargaining unit Physicians for Responsible Negotiation]. This tends to undercut previous arguments opposing union formation based on notions of professionalism."
Another strong argument for unionization is the development of "monopsony power" situations in some areas, with only one or two insurers completely dominating the marketplace. Dr, Michael Connair, vice president of the Federation of Physicians and Dentists, said that this problem affects other things besides collective bargaining. He cited Philadelphia as an example.
"In Philadelphia, 70% of the population is insured by one [insurer], which is intransigent," said Dr. Connair, an orthopedic surgeon in New Haven. "One reason that doctors are having difficulty paying malpractice premiums is that they cannot negotiate effectively" with such powerful health plans. "Insurers are strong-arming physicians into signing one-sided contracts that compromise care and squeeze doctors financially. Doctors are leaving in part because of the high malpractice rates and the failure of the monopsony to yield."
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