Physician unions are bad for patients, government report says.(News)

Allowing physicians to bargain collectively "will harm consumers financially and is unlikely to result in quality improvements," according to the Department of Justice and the Federal Trade Commission.

The comments were made as part of a 361-page report titled, "Improving Health Care: A Dose of Competition." The report is the culmination of a series of hearings held from February to October of 2003 on various aspects of health care competition, including group purchasing organizations, physician information sharing, and geographic market definition, in addition to physician unionization.

"This report represents almost 2 years of work including 27 days of joint hearings," outgoing FTC chairman Timothy Muris said at a press briefing. "We have seen dramatic increases in health care expenditures in the last 2 years. Unfortunately, all too often [these increases] don't produce improvements in quality of care. Our agencies agree that a dose of competition will help the health care marketplace to provide such care."

The report made six recommendations for improving competition within the health care marketplace. (See box.)

One recommendation urged state and federal government not to enact legislation allowing for physician collective bargaining. Instead, the report suggested, governments should work more vigorously to enforce existing antitrust laws. "The agencies believe that antirust enforcement to prevent the unlawful acquisition or exercise of monopsony power by insurers is a better solution than allowing providers to exercise countervailing power," the authors wrote.

The Union of American Physicians and Dentists, a 5,000-member independent labor union, disagrees. "While for-profit managed care plans conspire to delay and deny access to sophisticated and necessary diagnostic studies and treatment, entrenched pro-big business interests remain adamant that doctors and their patients should not have a level playing field," said UAPD president Dr. Robert Weinmann. "It is obvious that nothing worries the greed-encrusted barons of managed care more than the possibility that doctors will step outside their usual and customary professional associations and become active labor union protagonists."

Dr. Weinmann's advice to other physicians: "They should join their nearest doctors' union as fast as they can write the check."