Trustbusters’ crackdown on big tech: An analysis of competition policy and antitrust enforcement efficacy as reflected in the securities market

The article examines the transformation of unfair competition under conditions of digitalization and the growing dominance of platform-based business models. It argues that traditional anti-competitive practices increasingly acquire an algorithmic nature and are implemented through ranking systems, recommendation mechanisms, automated pricing tools, and large-scale data processing. The study identifies key algorithmic mechanisms of competitive distortion, including self-preferencing, visibility manipulation, algorithmic coordination, data opacity, interoperability restrictions, and the reinforcement of market power through network effects. It demonstrates that the interaction between data, algorithms, and platform infrastructure produces a new configuration of digital market power that challenges conventional competition law doctrines. The paper develops an integrated economic and legal model of regulatory response that combines ex post antitrust enforcement with ex ante preventive obligations. The proposed model includes algorithmic risk detection, legal qualification of conduct, proportional remedial measures (transparency requirements, algorithmic audits, interoperability duties), and compliance monitoring. Particular attention is paid to the evidentiary challenges associated with algorithmic opacity and the need for adapted standards of digital proof. The scientific novelty of the research lies in the conceptualization of a systemic framework linking algorithmic mechanisms, digital market structures, regulatory instruments, and digital evidence in the context of contemporary antitrust control.

In the United States today, one private company holds the digital keys to the nation's health. Epic Systems provides the electronic health record for 42.3% of acute care hospitals and controls over half (54.9%) of all acute care hospital beds, a concentration of market power unprecedented in modern healthcare IT. This paper investigates how Epic transformed from a small, privately held vendor into the dominant force shaping the electronic health record landscape, drawing on peer-reviewed literature, federal antitrust filings, and cross-national case studies. We chart its ascent from a unified-platform niche player, to market validation through Kaiser Permanente's multi-billion-dollar rollout, to rapid adoption under the HITECH Act. Quantitative analysis shows the U.S. hospital electronic health record market shifting from competitive to highly concentrated (Herfindahl-Hirschman Index > 2,500) after 2018, with Epic capturing nearly 70% of new hospital contracts in 2024. We examine the reinforcing mechanisms and standard practices, including network effects that add true interoperability value, high switching costs common to enterprise software, bundling practices, and workforce restrictions, that entrench this dominance, alongside alleged anti-competitive behaviors under active litigation. While some consolidation reflects legitimate business efficiencies and the inherent complexity of healthcare IT, the current level of market concentration poses significant governance challenges. International deployment failures in Norway, Denmark, Finland, and the United Kingdom reveal that Epic's success reflects market structures rather than clear technological superiority. Regulatory contrasts highlight how the European Health Data Space's mandatory interoperability, portability, and pre-market testing requirements are designed to prevent similar monopolization in the EU. We conclude with a reform blueprint that spans antitrust enforcement, structural separation, public utility models, and clinician-driven redesign, arguing that electronic health record systems must be governed as essential public health infrastructure. Confronting Epic's monopoly is critical to restoring competition, fostering innovation, and ensuring that digital health serves patients and the public good.

In the United States today, one private company holds the digital keys to the nation’s health. Epic Systems provides the electronic health record for 42.3% of acute care hospitals and controls over half (54.9%) of all acute care hospital beds, a concentration of market power unprecedented in modern healthcare IT. This paper investigates how Epic transformed from a small, privately held vendor into the dominant force shaping the electronic health record landscape, drawing on peer-reviewed literature, federal antitrust filings, and cross-national case studies. We chart its ascent from a unified-platform niche player, to market validation through Kaiser Permanente’s multi-billion-dollar rollout, to rapid adoption under the HITECH Act. Quantitative analysis shows the U.S. hospital electronic health record market shifting from competitive to highly concentrated (Herfindahl–Hirschman Index > 2,500) after 2018, with Epic capturing nearly 70% of new hospital contracts in 2024. We examine the reinforcing mechanisms and standard practices, including network effects that add true interoperability value, high switching costs common to enterprise software, bundling practices, and workforce restrictions, that entrench this dominance, alongside alleged anti-competitive behaviors under active litigation. While some consolidation reflects legitimate business efficiencies and the inherent complexity of healthcare IT, the current level of market concentration poses significant governance challenges. International deployment failures in Norway, Denmark, Finland, and the United Kingdom reveal that Epic’s success reflects market structures rather than clear technological superiority. Regulatory contrasts highlight how the European Health Data Space’s mandatory interoperability, portability, and pre-market testing requirements are designed to prevent similar monopolization in the EU. We conclude with a reform blueprint that spans antitrust enforcement, structural separation, public utility models, and clinician-driven redesign, arguing that electronic health record systems must be governed as essential public health infrastructure. Confronting Epic’s monopoly is critical to restoring competition, fostering innovation, and ensuring that digital health serves patients and the public good.

To examine, for the United States: (1) national trends in market competition using three approaches to operationalizing markets and (2) how competitive markets differ from concentrated ones for general newborn nurseries [GNNs], general pediatric inpatient units [GPIUs], neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], and pediatric emergency departments [PEDs]. This study describes hospital markets for the above most common hospital-based pediatric service lines. Antitrust enforcement guidelines characterize market structures as: "Competitive," "Concentrated," or "Unavailable" if ≥ 5, 1-4, or zero hospitals within a market provide each service, respectively. Trends were determined by the share pediatric population residing in each market structure in 2018 compared with 2011 using three different approaches to operationalizing markets: Healthcare Referral Regions [HRR], Neonatal Intensive Care Regions [NICR], and Pediatric Emergency Referral Regions [PERR]. Competitive markets were compared with concentrated ones in 2018 using demographic data and hospital characteristics. Data come from the Health Systems and Providers Database (HSPD) developed by the National Bureau of Economic Research and the American Community Survey. Since the HSPD provides a near census of US hospitals, only point estimates are presented. Irrespective of how markets were operationalized, the share of the national pediatric population living in competitive markets increased for NICU (3%-8% increase), PICU (21%-35%), and PED (30%-76%) services and remained stable for GNN services over the study period. Directionality of the change in share living in competitive GPIU markets depended on how markets were operationalized. Using HRRs, competitive (relative to concentrated) markets exhibited smaller declines in pediatric population size, larger non-white populations, and higher prevalence of children's hospitals. Market competitiveness for hospital-based pediatric services varies by service line, demographic and socioeconomic factors, and specific market definition used. Future studies should examine whether competitive markets offer better outcomes at lower prices and whether pediatric patients in concentrated markets require more protections.

ABSTRACT The Biden Administration pursued a set of ambitious competition policy initiatives in agriculture and agribusiness, primarily aimed at livestock and poultry supply chains, farm inputs, and food retailing. The initiatives included expanded antitrust enforcement; new US Department of Agriculture (USDA) contract regulations requiring poultry processors to disclose more information to growers; and USDA financial support for expanded capacity in meat processing. I summarize the initiatives, evaluate what we know about their likely impacts, and discuss open research and policy issues.

Moderating role of antitrust enforcement in the relationship between legal quality and corporate governance

Until recently, antitrust laws were rarely enforced in labor markets. Although the existence of labor market power has long been recognized, evidence only recently emerged that such market power regularly arises from sources that are actionable under antitrust law. Since 2010, antitrust agencies have substantially increased labor market enforcement actions. However, many questions relevant to enforcement remain unanswered, such as how to conduct market definition for labor markets and how best to incorporate concentration into models of the labor market. This article reviews how antitrust is beginning to be used in labor markets, the evidence for and against its use, and the remaining evidence gaps standing in the way of more effective use.

The impact of antitrust enforcement on peer firm innovation: An empirical analysis based on Chinese merger review

Antitrust challenges have increasingly shaped competitive dynamics across industries, particularly affecting small and low-income firms that struggle to coexist with dominant market players. This study introduces the intersection of antitrust regulation, corporate strategy, and innovation, emphasizing ethical leadership, motivational governance, and sustainable growth amid regulatory pressure. It highlights how companies navigate competition through adaptive business models, collaborative missions, and market-driven resilience, with particular attention to the food industry’s global landscape. Cultural preservation, regulatory compliance, and strategic diversification emerge as critical factors influencing firm survival and expansion. Drawing on international contexts—including the United States, Korea, and Indonesia—the introduction frames antitrust enforcement as both a constraint and a catalyst for innovation. Ultimately, the paper positions antitrust challenges not merely as legal obstacles but as opportunities for redefining competitiveness, equity, and long-term sustainability within modern capitalist economies.

This legal analysis concerns the antitrust litigation brought against the National Football League regarding its out-of-market broadcasting package, NFL Sunday Ticket. Plaintiffs alleged the NFL, in collaboration with DirecTV, unlawfully bundled all Sunday afternoon games into a single pack- age, preventing consumers from purchasing individual team games and inflating prices. The class action lawsuit, filed in 2015, covered a subscriber base of over 2.4 million residential customers and approximately 48,000 commercial establishments. In June 2024, a jury awarded over $4.7 billion in damages to the class. However, in August 2024, the trial judge granted judgment as a matter of law in favor of the NFL, ruling that the plaintiffs’ damages experts were inadmissible and no reasonable jury could find class-wide harm without their testimony. This paper outlines the legal framework for assessing the alleged conduct, including the application of the Sherman Antitrust Act and the scope of the Sports Broadcasting Act. It further analyzes the reasoning behind key judicial opinions, eval- uates how the court’s interpretation of evidence influenced the outcome, and considers the broader implications for antitrust enforcement in sports broadcasting.

Building Pro-Worker Artificial Intelligence

The Rising Instrumentalisation of Competition and Antitrust Enforcement

ANTITRUST, VAMPIRES, AND BLOODY ACQUISITIONS

Frenemies: Why the FTC Should Explore the Utility of State COPAs to Address Anticompetitive Consolidation in Healthcare 

Behavioral Antitrust in 2026

<p><span>The New Limits On Antitrust</span></p>

Big Tech, Antitrust and the Financial Markets Blind Spot

Heterogeneous Effects of Private Antitrust Enforcement on Collusive Behaviour

2025 Annual Antitrust Report: Class Actions in Federal Court