The American health care system has undergone tremendous transformation over the past few decades. The fee-for-service (FFS) health care system in which physicians enjoyed a great deal of autonomy has become a managed care system in which cost and utilization considerations play a larger role in physician decision making. Although physicians and other health care professionals are still patient advocates, this role often results in a conflict between their own economic interests and their duties to their patients.

Rather than depending on self-sacrificing health care professionals to advocate for them, patients need to assert their own power in the managed care arena. One way to gain such power is to use the class action device in litigation aimed at improving medical care quality, cost and access. Class actions, in fact, are likely to proliferate as managed care organizations (MCOs) grow and affect more patients’ lives. There are well-recognized dangers to using the class action device, but if used properly, it could prove a valuable remedy for patients.

Because the health care industry comprises over thirteen percent of the American economy, law enforcers increasingly apply antitrust law to all aspects of health care delivery and financing. Through antitrust enforcement, consumers receive the benefits of lower health care costs and improved health care services. To achieve further cost savings, health care providers are forming, as well as joining, many different types of provider network joint ventures. Providers form networks, expect ing “them to generate efficiencies, reduce excess capacity, improve utilization, permit greater specialization and enhance quality.” However, because they organize competing physicians and enable them to collaborate on prices and set fee schedules, provider networks raise serious antitrust concerns. Consequently, the federal government and courts are increasingly focusing their antitrust enforcement efforts on the formation and anticompetitive activities of provider networks.

In Part I, this Note addresses the degree to which network providers must be economically and financially integrated to legally collaborate and set prices. Part II briefly explains the procedures one may use to enforce the federal antitrust laws. Following this explanation of antitrust enforcement procedures, Part III discusses the relevant statutory and case law applicable to health care provider networks.

Despite education campaigns about the health hazards associated with smoking and the use of smokeless tobacco, teenage use of tobacco products has reached epidemic proportions. Recent studies indicate that adolescent smoking is on the rise, and that children are beginning to smoke at progressively earlier ages. “Nearly 3,000 young people start smoking each day,” accounting for more than one million new smokers each year. In addition, ninety percent of all new smokers are under the age of eighteen.

Although young people are generally aware of the serious, long-term health risks associated with tobacco use, studies suggest that those who smoke do not usually view those risks as applying to them personally. Furthermore, evidence shows that young people who begin to smoke know about the addictive properties of nicotine, but do not believe that they will become addicted. For these reasons, in August 1995, the Food and Drug Administration (FDA) proposed strict regulations aimed at reducing the number of children and adolescents who smoke. Several of these provisions target cigarette advertisements aimed at minors.