Considering a New Structure: The Health Services Holding Company

For a review of the political process which reflected public opinion, see Somers H.M. Ramsey A. , Medicare and the Hospitals: Issues and Prospects (Brookings Institute, Washington, D.C.) (1967) at 1-24, 243–47.

Somers H.M. , Seven Forces that are Shaping the Future of Hospitals, Trustee 33(1): 27–30 (January 1980).

Medical Bill in U.S. Tops 10% of GNP, Blade Toledo , July 17, 1983, Al.

Hospital Survey and Construction (Hill-Burton) Act of 1946, 42 U.S.C. §§291-291o.

Social Security Amendments of 1965, Pub. L. No. 89-97, 79 Stat. 286 (adding Titles XVII and XIX to the Social Security Act).

See generally Kinzer D.M. , Health Controls out of Control: Warnings to the Nation from Massachusetts (Teach'em, Inc., Chicago) (1977).

Congress enacted such limits as part of the Tax Equity and Fiscal Responsibility Act of 1982, Pub. L. No. 97-248, 96 Stat. 324 (1982) (codified as amended in scattered sections of U.S.C.)

Social Security Amendments of 1983, Pub. L. No. 98-21, §§601-07, 97 Stat. 65, 149–72 (1983) (prospective payment for Medicare inpatient hospital services based on DRGs).

See generally Bradford C. , The Hospital Capital Crisis: Issues for Trustees, Harvard Business Review 60(5): 56–68 (September/October 1982).

National Health Planning and Resources Development Act of 1974, Pub. L. No. 93-641 (codified as amended at 42 U.S.C. §§300k-300m-6 (Supp. V 1981)). See also Health Planning; Corporate Reorganization, in Hospital Law Manual (Aspen Systems Corp., Germantown, Md.) (1983) at ¶6-2 and ¶4-1.

Although cost reimbursement is being phased out for Medicare payments for inpatient care, it remains the basis for outpatient care and payment for capitalization. In addition, cost is the basis for Medicaid payment and rate-setting in some states, some Blue Cross plans, and certain other payment sources.

I.R.C. §§511-513 (West Supp. 1983); Rev. Rul. 375, 1968–2 C.B. 245; Rev. Rul. 376, 1968–2 C.B. 246. See Carle Foundation v. United States, 611 F.2d 1192 (7th Cir. 1979), cert. den., 101 S.Ct. 85 (1980) (sales by tax-exempt hospital pharmacy to non-exempt clinic and clinic's private patients give rise to unrelated business taxable income).

I.R.C. §501 (West Supp. 1983).

See, e.g., 42 C.F.R. §§405. 401–405.488 (1982).

Henn H.G. , Handbook of the Law of Corporations and Other Business Enterprises (West Publishing Co., St. Paul, Minn.) (2nd ed. 1970) at 457.

Zuckerman H.S. , Multi-Institutional Systems: Their Promise and Performance, in Multi-Institutional Hospital Systems ( Zuckerman H.S. , ed.) (Hospital Research and Educational Trust, Chicago) (1979) at 10.

Corporate Reorganization, in Hospital Law Manual, supra note 11, ¶1–5.

Id. §3.

See id. ¶1–6.

I.R.C. §509 (West Supp. 1983); Hospital Law Manual, supra note 11, ¶1–7.

See Bradford, supra note 10.

Hospital Law Manual, supra note 11, §3.

Id.

Brown M. Lewis H.L. , Hospital Management Systems: Multi-Unit Organization And Delivery of Health Care (Aspen Systems Corp., Germantown, Md.) (1976) at 259-74.

Zuckerman , supra note 16, at 35-36.

See generally Hospital Bldg. Co. v. Trustees of Rex Hosp., 425 U.S. 738 (1976) (alleged attempt of private tax-exempt hospitals to block expansion and relocation of proprietary hospital involves out-of-state lenders, patients and hospital suppliers, sufficiently affecting interstate commerce to give rise to a cause of action under Sherman Anti-Trust Act).

Standard Oil Co. v. United States, 221 U.S. 1 (1911) (classic antitrust case; decree ordered dissolution of holding company which combined various petroleum corporations with intent to monopolize trade).

See United States v. Paramount Pictures, Inc., 334 U.S. 131 (1948) (sustained injunctions against major motion picture producers, distributors, and exhibitors who were charged with conspiring to restrain and monopolize trade; vertical control violates Sherman Anti-Trust Act).