Seeing that Medicare is the largest player by far and it is a gov service, they will set the price. I have no issue with a usual and customary fee schedule ceiling but you can not tie that schedule to the largest insurer which happens to be a gov entity. Also, a 24 hour ER is much like a specialty store and as such should be able to charge more than a general clinic.
The Robinson-Patman Act was intended to keep business from undercutting another. Not to restrict profit.
When it comes to pre-existing, those that have abused their body should not be automatically accepted at the same price as someone who has not. It only drive up the price for the responsible party.
Hence the "quotations"
.
[/QUOTE]
Heres some more info on the Robinson-Patman Act that explains why it probably is not aplicable to health care. Looks like #19 knocks it out. I think it could also be argued that the services being sold to an insurance co. or Medicare are being sold in bulk quantities and an individual's are not.
In order to bring the substantive portions of the Act into play, there must be
two or more consummated sales,
reasonably close in point of time,
of commodities,
of like grade and quality,
with a difference in price,
by the same seller,
to two or more different purchasers,
for use, consumption, or resale within the United States or any territory thereof,
which may result in competitive injury. Furthermore,
the "commerce" requirement must be satisfied.11
These jurisdictional elements are interpreted strictly and technically, and three of them may be of particular interest. First, as the first element indicates, the plaintiff must establish that actual sales occurred. The Act does not apply, for example, to long term leases; to mere offers to sell; to acting as an intermediary between a seller and its customers; or to licensing computer software. 12 Second, as the third element indicates, the Act applies only to commodities; it does not apply to intangible products. Thus, for example, electricity has been classified as a commodity subject to the Act, because "[e]lectric power can be felt, if not touched. It is produced, sold, stored in small quantities, transmitted, and distributed in discrete quantities." 13
By contrast, courts have concluded that the Act does not apply to intangible products such as cellular telephone service and cellular telephone activation service; 14 the printing of comic books;15 newspaper advertising; 16 real estate leases; 17 long distance voice telecommunications services; 18 and cable television service. 19 When a transaction involves both the sale of goods and the sale of services, the Act applies "only if the 'dominant nature' of the transaction is a sale of goods."20
Brian