* Even as health-care costs spiraled during the last 10 years, many hospitals and doctors shied away from cooperative ventures - some for competitive reasons, others for fear of antitrust laws. But cooperation is now at the heart of the Clinton administration's reform package.
On Wednesday, the Justice Department and the Federal Trade Commission (FTC) unveiled detailed guidelines designed to ease fear of antitrust laws, foster collaboration, and cut costs. The administration also committed to answering all health-care antitrust questions within 90 to 120 days.
``These actions are pro-competition, pro-collaboration, and pro-consumer,'' Hillary Rodham Clinton said, predicting that they will save consumers money.
The guidelines create ``antitrust safety zones'' in the health-care field by collecting and clarifying rules and regulations that were scattered in letters, speeches, and rulings.
``People in small communities honestly didn't know what the rules were,'' said Anne Bingaman, head of the Justice Department's antitrust division. ``This is an effort to clarify, to state in one simple place what those rules are.''
Among other things, the guidelines will allow some joint purchasing of medical equipment, some hospital mergers, and the exchange of price and cost information as long as it is not used to fix prices.
The new policy statement received a warm welcome from the American Hospital Association, which raised the antitrust issue more than a year ago.
But AHA President Dick Davidson and others in the health-care industry note that the guidelines still leave many important antitrust issues unanswered. For instance, they do not address cooperation in providing services, like obstetrics, or the development of provider networks.
``Everything that's happening [in health care now] revolves around hospitals, doctors, nursing homes, and other providers creating a network to give the patient the full range of services,'' says Gaelyn De Martino, the Washington counsel for the AHA. ``I think there still has to be more dialogue between the agencies and the health-care industry.''
The harshest critic of the guidelines was FTC staff member Deborah Owen, who called it an ``antitrust exemption.''