法律翻译 | 最高费用协议违反《谢尔曼法》——亚利桑那州诉马里科帕县医学会案

译者 | 孙书朋 西南政法大学国际法学硕士

一审 | 程子珊 USC LL.M. 

二审 | Ellen Chen Cornell LL.M. 

编辑 | 陈玉昕 香港中文大学 LL.M.

         李建云 中国政法大学硕士

责编 | 李薇 浙江工商大学本科

原文链接：

https://supreme.justia.com/cases/federal/us/457/332/#tab-opinion-1954590

Arizona v. Maricopa County 

Medical Society

亚利桑那州诉马里科帕县医学会

Respondent foundations for medical care were organized by respondent Maricopa County Medical Society and another medical society to promote fee-for-service medicine and to provide the community with a competitive alternative to existing health insurance plans. The foundations, by agreement of their member doctors, established the maximum fees the doctors may claim in full payment for health services provided to policyholders of specified insurance plans. Petitioner State of Arizona filed a complaint against respondents in Federal District Court, alleging that they were engaged in an illegal price-fixing conspiracy in violation of § 1 of the Sherman Act. The District Court denied the State's motion for partial summary judgment, but certified for interlocutory appeal the question whether the maximum fee agreements were illegal per se under § 1 of the Sherman Act^[1]. The Court of Appeals affirmed the denial of the motion for partial summary judgment and held that the certified question could not be answered without evaluating the purpose and effect of the agreements at a full trial.

被上诉人马里科帕县医学会和另一家医学会成立了被上诉人医疗护理基金会，以推广按服务付费式医疗（fee-for-service medicine）并为社区提供具有竞争力的现存医疗保险替代性方案。经由成员医生一致同意，该基金会设置了医生可以就医疗服务向特定保险投保人主张全额支付的最高费用。上诉人亚利桑那州在联邦地区法院针对被上诉人提起诉讼，称被上诉人参与了非法定价共谋行为（price-fixing conspiracy），违反了《谢尔曼法》第1条。地区法院拒绝了亚利桑那州要求部分简易判决的动议，但是允许其就最高费用协议（maximum fee agreements）本身是否违反《谢尔曼法》第1条提起中间上诉^[1]。上诉法院维持了地区法院拒绝部分简易判决的裁定，并认为如果在未能以全面审判的方式评估最高费用协议的目的和影响，就无法回答被允许临时上诉的问题。

Held: The maximum fee agreements, as price-fixing agreements, are per se unlawful under § 1 of the Sherman Act.

裁定：根据《谢尔曼法》第1条的规定，最高费用协议本身作为定价协议是违法的。

(a) The agreements do not escape condemnation under the per se rule^[2] against price-fixing agreements because they are horizontal and fix maximum prices^[3]. Horizontal agreements to fix maximum prices are on the same legal -- even if not economic -- footing as agreements to fix minimum or uniform prices. The per se rule is violated here by a price restraint that tends to provide the same economic rewards to all practitioners regardless of their skill, experience, training, or willingness to employ innovative and difficult procedures in individual cases. Such a restraint may also discourage entry into the market, and may deter experimentation and new developments by individual entrepreneurs.

(a) 依据本身违法原则^[2]，最高费用协议与定价协议一样是违法的，这是因为最高费用协议是横向维持最高价格^[3]。尽管横向维持最高价格协议与维持最低价格协议或者统一价格协议的经济基础不一样，但是它们的法律基础是一致的。在该价格限制下，所有的执业医师往往都能获得相同的经济奖励，而不考虑其技能、经验、所接受的培训或者其在个案中是否愿意进行具有创新性和高难度的手术，因此该价格限制违反了本身违法原则。此外，该种限制可能会阻碍他人进入市场，并且会让经营者不愿开展实验或者新的研发活动。

(b) Nor does the fact that doctors, rather than nonprofessionals, are the parties to the price-fixing agreements preclude application of the per se rule. Respondents do not claim that the quality of the professional services their members provide is enhanced by the price restraint, and their claim that the price restraint will make it easier for customers to pay does not distinguish the medical profession from any other provider of goods or services.

（b）医生是价格维持协议的当事方，而不是非专业人士，这一事实并不会排除本身违法原则的适用。被上诉人并未主张价格限制会提高其成员所提供的专业服务的质量，并且被上诉人称价格限制会让顾客更便捷地付款，这一主张并不能区分医疗专业人员和其他商品或者服务供应商。

(c) That the judiciary has had little antitrust experience in the health care industry is insufficient reason for not applying the per se rule here. "^[4]The Sherman Act, so far as price-fixing agreements are concerned, establishes one uniform rule applicable to all industries alike."  United States v. Socony-Vacuum Oil Co..

（c）司法机关在医疗领域的反垄断经验不足这一事实不能作为排除本案适用本身违法原则的充分理由^[4]。在 United States v. Socony-Vacuum Oil Co.一案中，法院认为“就定价协议而言，《谢尔曼法》确立了适用于所有类似行业的统一规则”。

(d) The per se rule is not rendered inapplicable in this case for the alleged reason that the agreements in issue have procompetitive justification. The anticompetitive potential in all price-fixing agreements justifies their facial invalidation even if procompetitive justifications are offered for some. Even when respondents are given every benefit of doubt, the record in this case is not inconsistent with the presumption that respondents' agreements will not significantly enhance competition. The most that can be said for having doctors fix the maximum prices is that doctors may be able to do it more efficiently than insurers, but there is no reason to believe any savings that might accrue from this arrangement would be sufficiently great to affect the competitiveness of these kinds of insurance plans.

（d）本身违法原则并不因本案所争议的协议可以促进竞争而不适用。尽管有些价格维持协议能够促进竞争，但是所有的价格维持协议都可能会阻止竞争，因此有足够理由证明此类协议在表面上是无效的。就算我们姑且认为被上诉人所言为真，但是本案的卷宗符合这样一种推定，即被上诉人的协议并不会明显促进竞争。让医生维持最高价格最多使其较承保人而言效率更高，但是没有理由认为此种安排所累计的储蓄足够多以至于会影响此类保险的竞争力。

(e) Respondents' maximum fee schedules do not involve price-fixing in only a literal sense. As agreements among independent competing entrepreneurs, they fit squarely into the horizontal price-fixing mold. 

(e)被上诉人的最高费用计划不涉及字面意义上的定价。作为独立竞争企业家之间的协议，它们完全符合横向定价模式。

Each of the foundations is composed of individual practitioners who compete with one another for patients. Neither the foundations nor the doctors sell insurance, and they derive no profits from the sale of health insurance policies. The members of the foundations sell medical services. Their combination in the form of the foundation does not permit them to sell any different product. Their combination has merely permitted them to sell their services to certain customers at fixed prices, and arguably to affect the prevailing market price of medical care.

每一个基金会都是由独立的执业医师组成，他们为了赢得客户而互相竞争。基金会和医生均不销售保险，并且他们未从销售医疗保险中获利。基金会的成员只提供医疗服务。他们以基金会的形式联合，但并不允许销售不同的产品。他们的联合仅仅让他们可以固定的价格向特定顾客提供服务，并且影响了医疗护理的现行市场价格。

The foundations are not analogous to partnerships or other joint arrangements in which persons who would otherwise be competitors pool their capital and share the risks of loss as well as the opportunities for profit. In such joint ventures, the partnership is regarded as a single firm competing with other sellers in the market. The agreement under attack is an agreement among hundreds of competing doctors concerning the price at which each will offer his own services to a substantial number of consumers. It is true that some are surgeons, some anesthesiologists, and some psychiatrists, but the doctors do not sell a package of three kinds of services. If a clinic offered complete medical coverage for a flat fee, the cooperating doctors would have the type of partnership arrangement in which a price-fixing agreement among the doctors would be perfectly proper. But the fee agreements disclosed by the record in this case are among independent competing entrepreneurs. They fit squarely into the horizontal price-fixing mold.

基金会不同于合伙企业以及其他联合经营形式，后者的成员本是竞争者，但是他们集中资金、共担风险和损失、共享营利机会。在此类合资企业中，合伙企业被视为与市场上其他销售者竞争的单一实体。本案所争议的协议是众多互相竞争的医生就其向广大顾客提供服务的价格所达成的协议。诚然，在这些医生中有的是外科医生，有的是麻醉师，还有的是精神科医生，但是他们并没有将三种不同的服务捆绑销售。如果一家诊所以固定费用提供全科医疗服务，那么互相合作的医生之间的关系就类似于合伙企业，此种情形下，定价协议是完全适当的。但是，本案案卷所披露的费用协议形成于相互竞争的独立经营者之间。该费用协议刚好符合横向统一定价模型。

脚注