Under dual pressures of compliance and reputation: the impact of antitrust law on corporate green economic narratives

Healthcare consolidation has transformed physician employment, with 74% now working for health systems or corporate entities. While physicians increasingly consider collective bargaining to address these changes, the legal frameworks and practical pathways remain unclear, particularly for highly specialized fields like neurosurgery. We conducted a policy analysis synthesizing federal labor statutes, National Labor Relations Board rulings, judicial decisions, and comparative frameworks from international healthcare systems and US industries with similar characteristics. Analysis focused on private sector physicians covered under the National Labor Relations Act. Recent legal developments have created new possibilities within persistent constraints. The 2022 Piedmont Health Services decision clarified that employed physicians focused on patient care may unionize under the National Labor Relations Act. However, private practice physicians remain excluded as independent contractors, and antitrust law prohibits collective negotiation without structural integration. The 2023 withdrawal of antitrust "safety zones" eliminated predictable compliance pathways while allowing case-by-case innovation. Available options include messenger model networks for information sharing, Independent Practice Associations with genuine financial integration, and fully integrated cooperatives. Professional societies can advocate but cannot bargain collectively. International models and US industries demonstrate that collective frameworks can preserve individual contract flexibility and merit-based compensation. Neurosurgery's unique characteristics-small specialty size, high revenue generation, emergency obligations, and practice diversity-require tailored approaches to collective representation. While legal barriers persist, viable pathways exist within current frameworks. Success depends on matching organizational models to regional market conditions and practice characteristics. As healthcare consolidation continues, understanding these options becomes essential for neurosurgeons seeking to preserve professional autonomy and economic sustainability, whether through collective action, individual negotiation, or hybrid approaches.

The article is devoted to the study of the features of antitrust regulation of the pharmaceutical industry under sanctions restrictions. Unlike existing approaches, the authors consider the interaction of exogenous factors (sanctions) and endogenous regulatory mechanisms (antitrust legislation) as a unified system requiring comprehensive analysis. An empirical analysis of statistical data for the period 2022–2024 on pharmaceutical drugs with patent protection expiring in 2024–2026 is conducted. The methods used include structural analysis of market segments, price dynamics analysis, and concentration assessment by distribution channels. The necessity of adapting traditional methods of antitrust control to the specifics of pharmaceutical markets functioning under external restrictions is substantiated. The author draws attention to the formation of asymmetric competition conditions, where market access is determined not only by economic but also by geopolitical factors. Data on the dominance of government distribution channels (hospitals and preferential programs account for more than 55% of the market in terms of sales) and significant volatility of the main indicators of the industry (10.6% decline in sales in 2023 followed by 25.8% growth in 2024) are provided. Differentiated impact of sanctions on various market segments is revealed, particularly critical reduction in high-cost nosologies volumes. Average price growth in certain segments up to 39% is noted. The obtained results confirm the conclusions of previous studies about the need for comprehensive industry stimulation, while simultaneously revealing new aspects of the interaction between sanctions restrictions and competitive environment. It is noted that traditional market concentration indicators may not reflect the real competitive situation under new conditions, requiring the development of adapted antitrust analysis methods.

The article provides a comprehensive scholarly analysis of the foundations of labor and business law in the United States as integral components of a federal legal system. It examines the sources of legal regulation, the interaction between federal and state legislation, and the role of case law in shaping legal practice. Particular attention is given to the “employment at will” doctrine as a defining feature of the American labor model, as well as to the mechanisms for protecting employees’ rights within the framework of federal statutes and supervisory agencies. The study also explores the principles of corporate regulation, legal forms of business organization, and the specific features of U.S. antitrust legislation. Special emphasis is placed on contemporary challenges related to economic digitalization, the expansion of the gig economy, the transformation of employment relations, and increasing regulatory scrutiny of large corporations. The article concludes that the American regulatory model combines a high degree of economic freedom with relatively limited social guarantees, ensuring labor market flexibility and a favorable investment climate, while significantly influencing the development of international legal standards in labor and business law.

India's move from a controlled economy to a liberalized market system needed a robust foundation for competition regulation in order to control how the market worked and make the economy more efficient. The Competition Act, 2002, which was a big change from the Monopolies and Restrictive Trade Practices Act, 1969, set up the Competition Commission of India (CCI) as the main regulating authority. The Commission's job is to make sure that markets are fair and competitive by blocking agreements that are not fair, controlling the abuse of dominant positions, and keeping an eye on mergers. This paper critically examines the efficacy of the CCI by analyzing its institutional performance, enforcement techniques, and contributions to the development of Indian competition law doctrine. It looks at important court decisions that have changed how the Competition Act, 2002 is used and understood. These include Competition Commission of India v. Steel Authority of India Ltd., Excel Crop Care Ltd. v. Competition Commission of India., DLF Ltd. v. Competition Commission of India., Google LLC v. Competition Commission of India., and Bharti Airtel Ltd. v. Competition Commission of India. The report also talks about some of the CCI's biggest successes, such making merger control more open, enforcing antitrust laws more effectively, and pushing for more competition. However, it points out several problems that make the Commission less effective, such as delays in making decisions, a lack of technical knowledge, constraints on enforcement, and difficulties in regulating new digital markets that have data dominance and network effects. Moreover, jurisdictional overlaps with sectorial regulators continue to hinder effective enforcement and create uncertainty. The study uses a doctrinal and analytical method to look at how the CCI works by looking at academic literature, statutory provisions, and court decisions. It says that even while the Commission has done a lot to make India more competitive, we still need to build institutions, change procedures, and use new regulatory powers to fix problems in the market. The paper finishes with suggestions for changes that will make the CCI more effective, especially in light of digital economies and global competition trends. These changes will help achieve the goals of consumer welfare, market efficiency, and fair competition. Key Words: Competition Law, Competition Commission of India, Anti-Competitive Agreements, Abuse of Dominance, Cartelisation, Digital Markets, Consumer Welfare.

Health care consolidation continues to increase in the United States. Most of the evidence focuses on horizontal consolidation or vertical consolidation between hospitals and physician practices. The lack of comprehensive and longitudinal data identifying insurer and hospital vertical consolidation has limited study of the prevalence, variations, and impact of this form of consolidation. Therefore, we created a novel dataset of hospital-Medicare Advantage (MA) contract consolidation from 1980 to 2024. We illustrate the power of this novel dataset through analysis of annual trends in hospital-MA contract consolidation and state-level geographic variation in the share of hospitals consolidated with MA contracts. We also show that a quarter of hospital integrated MA contracts are owned by an MA insurer that owns other non-hospital integrated MA contracts. We make this dataset public to facilitate research on hospital-MA contract consolidation that can inform health care policy and anti-trust law.

In 2015, in In re National Football League’s Sunday Ticket Antitrust Litigation, four plaintiffs filed a class action lawsuit against the National Football League (NFL) alleging that the league violated antitrust laws through its contract with NFL Sunday Ticket—a programming package that the NFL advertises as “the ultimate fan experience.” Although the Sports Broadcasting Act has long protected the NFL from antitrust challenges to its telecasting contracts, some of these contracts, like the one with NFL Sunday Ticket, may not fall under its purview. The case is currently working through the appeals process, and its implications could completely alter the American sports broadcasting landscape. This Note examines the consequences of both potential outcomes of the litigation, ultimately arguing that a ruling for the plaintiffs would create a more competitive market for broadcasting rights which would benefit consumers. Additionally, because the NFL and other professional sports leagues are now multi-billion-dollar industries, this Note argues that Congress should repeal the Sports Broadcasting Act to create a legal landscape that best accomplishes the goals of the Sherman Antitrust Act.

Abstract The emerging relationship between fintechs and banks has revealed antitrust's antiquation. At one time, scholars predicted that fintechs could democratize banking while providing a critical source of competition. But then banks began to acquire their digital rivals: about 900 acquisitions of fintechs have taken place since 2021. By merging or partnering, banks have squelched competition in an already concentrated market. Antitrust's absence in bank‐fintech deals is additionally curious because enforcers recognize that digital platforms such as fintechs are prone to monopolization. Despite this landscape, enforcers have asserted that the rise of fintechs should make antitrust even more deferential to bank mergers. The problem is that antitrust law adheres to an orthodox brand of economic theory about how people ostensibly behave. At its root, antitrust cannot intervene in most scenarios because rational actors are supposed to correct markets. This article shows that consumers in the digital era cannot always detect or mitigate their injuries, suggesting that antitrust is underenforced in fintech and other innovative sectors. Just as troublesome is the outdated assumption that consumers suffer harm as a collective group. With digital markets, anticompetitive conduct may injure only certain people such as low‐income persons. Recognizing these issues, the Department of Justice (DOJ) and Federal Trade Commission (FTC) issued new merger guidelines that seem to jettison outdated assumptions about when markets will self‐correct. The primary assertion of this article is that to preserve the promise of fintech and its ability to democratize financial services, the courts should embrace the agencies’ new approach.

ABSTRACT Antitrust laws mandate review of mergers and acquisitions (M&As) that exceed an asset size threshold based on accounting standards that exclude most intangible capital. We show that this exclusion leads to thousands of intangible‐intensive M&As being nonreportable. Acquirers in nonreportable deals achieve higher equity values and price markups, especially when consolidating product markets. Furthermore, nonreportable pharmaceutical deals are three times more likely to involve overlapping drug projects, which are subsequently 40% more likely to be terminated. Our results suggest that the growth of intangible assets may exacerbate market power through nonreportable consolidation of the sectors most concerning for consumers.

Competition plays a crucial role in driving innovation in the industry of human genetics and genomics technologies. However, the US's policy on competition (such as enforcement of antitrust laws) has shifted over time, affecting the level of regulatory scrutiny that business decisions in the industry will receive. Here, we offer an overview of this changing legal landscape, noting key policy changes at the Federal Trade Commission (FTC) and Department of Justice (DOJ) relevant to the human genetics and genomics industry. Focusing on the regulatory challenge of Illumina's acquisition of Grail as a case study, we highlight how shifting anti-competition enforcement policy could affect spin-offs, startups, and industry consolidations. Balancing competition and consumer protection policies remains essential for the continued advancement of human genetic and genomic technologies. We offer this perspective in the hopes that it will help inform scientists in the field of the relevant legal considerations and stimulate discussions to shape policy-public and private alike-in ways that promote responsible innovation in genetic and genomic science and technology.

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 subject of the study is the issue of changing the role of the president in the political system of the United States of America in the context of the socio-economic challenges of industrial modernization in the late 19th and early 20th centuries. The subject of the study is the activities of the country's 26th leader, Theodore Roosevelt (1901–1909), who, taking advantage of the nationwide demand for active government policy, carried out "square deal" reforms aimed at combating monopolies and weakening interclass contradictions. The author examines in detail such aspects of the topic as the use of presidential executive orders, as well as the relationship between the head of state and Congress and the judicial branch of government. Particular attention is paid to the study of the White House's personnel policy and its influence on the political course of the Republican administration. The purpose of the article is to analyze those practical steps of T. Roosevelt that contributed to the formation of the modern institution of the presidency. Public speeches and letters from the 26th President of the United States on domestic political issues were used as a source. The methods of historicism and objectivism were actively used in the study, and comparative and problem-chronological approaches were used to analyze the reforms of the "square deal" and identify patterns in individual executive orders. The novelty of the study lies in its examination of the key steps taken by the Roosevelt administration to expand the powers of the executive branch. It has been proven that the reforms of the "Square Deal," in particular the Elkins and Hepburn antitrust laws, the Employer Liability Act, and the use of labour arbitration, contributed to more active intervention by the federal government in socio-economic processes. Another important factor in the expansion of presidential powers was the transfer of officials to a civil service system free from party patronage. In addition, T. Roosevelt resolutely pursued an environmental policy, using the law on antiquities to create new reserves. Based on the results of the study, it was concluded that the period of T. Roosevelt's rule became significant for the evolution of the institution of the presidency. The main conclusion of the study is that Roosevelt's personal qualities, especially his desire to take active measures to support strong executive power, played a major role in promoting the "square deal" reforms and executive orders of the White House.

The article examines problems in the application of antitrust legislation to the wholesale market for electric energy and capacity in the Russian Federation. The key features of the wholesale electricity market that determine the specifics of antitrust regulation are revealed: technological dependence on infrastructure, impossibility of storing electricity, the need for instant balancing of supply and demand, high barriers to entry and natural concentration of production. The current criteria for determining the dominant position of economic entities and the mechanisms for their application in light of the specific features of the power industry are analyzed. It is noted that existing legal norms contain internal contradictions and do not take into account sectoral characteristics of the electricity market. It is shown that the dominance criteria include elements of entities’ behavior, which contradicts the basic principles of antitrust regulation. It is determined that ex post market modeling violates the principle of legal certainty. The conclusion is drawn that a systemic adjustment of the legislation is necessary, taking into account the technological and economic characteristics of the power sector, including a revision of the dominance criteria and the streamlining of the sanctioning mechanism.

This study aims to analyze unfair business competition practices and their resolution mechanisms in government procurement of goods and services in Indonesia using Lawrence M. Friedman's legal system theoretical framework. The study method used is normative legal research with a legislative, conceptual, and case study approach, which is analyzed qualitatively through a review of legislation, decisions of the Business Competition Supervisory Commission (KPPU), and relevant legal literature. Case studies were conducted by analyzing three KPPU decisions that represent patterns of tender collusion in procurement, namely the Revitalization of Taman Ismail Marzuki (TIM) Phase III case, the provision of clean water in North Lombok, and the construction of the Prabumulih Mall. The novelty of this research lies in the simultaneous integration of weaknesses in legal structure, legal substance, and legal culture to assess the effectiveness of antitrust law enforcement in the procurement sector. The results of the study show that the main obstacles to the enforcement of business competition law not only stem from regulatory loopholes and definitions of norms that are not yet operational, but are also influenced by institutional capacity constraints, weak inter-agency coordination, and a permissive culture towards collusion in procurement practices. This study emphasizes that strengthening the effectiveness of law enforcement requires practical measures such as refining the norms prohibiting collusion, integrating sanctions and a database of violations into the national e-procurement system, and strengthening the synergy between KPPU and LKPP through a post-decision monitoring mechanism to prevent repeat violations. The conclusion of the study states that regulatory reformulation, strengthening of supervisory institutions, and renewal of the culture of compliance are key prerequisites for the realization of transparent, fair, and accountable procurement governance.

Antitrust law naturally brings about a clash of different views on the role of the state in the economy. On one side are liberals who oppose any regulation of competition, and on the other are those who strongly support government intervention. Both sides have their supporters, but neither has provided solid scientific evidence to fully back up their arguments. Recently, EU competition policy has started to reflect broader social goals as well. However, many of these goals are not the main purpose of antitrust rules—they are more like positive side effects. The main focus should remain on maintaining a healthy competitive environment. Antitrust rules shouldn’t be used as a political tool to achieve other goals that are better handled through direct regulation. Of course, every area of law has to evolve as society changes. But even so, it should keep its core purpose and not turn into a system that tries to manage every small issue in detail.

Abstract How do public agencies manage diverse programs under limited budgets? Resource constraints force agencies to prioritize tasks, requiring strategic decisions about how to allocate resources effectively. In this paper, I develop a gametheoretical model that explores how agencies shape and restructure their task portfolios under budgetary constraints. In response to budget reductions, I argue that agencies reallocate resources by prioritizing more efficient tasks for improved performance, within their portfolios. To test my theoretical claims, I analyze an original dataset of antitrust cases filed by the U.S. Antitrust Division (AD) from 1970 to 2019. Using compositional analysis, I find systematic associations between budgetary changes and the AD’s litigation portfolios. Specifically, budget cuts are associated with a higher share of antitrust criminal cases—the most efficient type for improving performance metrics—and with relatively lower shares for other case types. This study offers new insight into how public agencies navigate budgetary constraints to achieve their public missions while meeting performance expectations.

The integration of strategic digital assets, such as big data and algorithms, within e-commerce merger transactions creates new competition risks. These risks have not been adequately addressed by conventional due diligence regulations in Indonesia. This study aims to analyze the validity of sensitive information exchange during the pre-merger due diligence process viewed from an antitrust law perspective. Furthermore, this study identifies the legal implications of the oversight time-lag in the GoTo merger case. Utilizing a normative legal research method with statutory, comparative, and case approaches, this research compares the post-merger notification regime in Indonesia (Law Number 5 of 1999) with the gun-jumping doctrine and pre-merger notification mechanism in the United States (Sherman Act & HSR Act). The results indicate that the absence of a waiting period and specific rules regarding data exchange protocols in Indonesia renders the digital asset due diligence process highly risky. Such risks may serve as a vehicle for covert cartels or the premature transfer of beneficial ownership. The GoTo case study reveals that the integration of a digital ecosystem involving 55 million users’ data occurred prior to the KPPU determination. The determination was issued only 1 year after the transaction, thereby creating barriers to entry that went undetected at an early stage. This study concludes that there is a need to harmonize antitrust law with data protection law. This harmonization can be achieved by adopting the clean team mechanism and transitioning to a pre-merger notification system to prevent data monopolies in the digital economy.

The article aims to explore the theme of Cross-media ownership, in order to understand its impact on media pluralism within the Indian market. This would include analyzing the detrimental impact of such ownership model on freedom of speech and expression, which intends to resolve the dispute between media pluralism as a facet of Article 19(1)(a) of the Indian against freedom of trade under Article 19(1)(g), and their reasonable restrictions, respectively. This would lead the readers to understand the constitutional possibility and scope of regulating the Cross-media ownership in India, which is already under scrutiny in foreign jurisdictions. Along with this, the article will also discover the justification of antitrust laws being ignorant of harm caused by media conglomeration leading to depressed variability in media pluralism.

ABSTRACT A review of cartel cases decided by the Competition Commission of India (“CCI”) between 2009 and 2024 reveals that in most cases directors or key managerial personnel have been closely involved in effecting cartel arrangements. While the CCI has used relevant statutory provisions to indict these individuals, the sanctioning mechanism has been largely inadequate for two reasons. First, the penalty imposed by the CCI has been grossly inadequate. Second, the CCI has been inconsistent in applying sections 48(1) and 48(2) of the Competition Act, 2002 in fixing accountability on company executives found to have indulged in cartelisation. Due to this inadequacy and inconsistency, the CCI has failed to create sufficient deterrence for individuals. In this article, we explore corporate law to address the issue of under-deterrence with specific reference to directors’ duties and disqualification provisions under the Companies Act, 2013.

Vertical Restraints of Trade as Contractual Integration: A Synthesis of Relational Contracting Theory, Transaction-Cost Economics, and Organization Theory