American Medical Ass'n v. United States

130 F.2d 233
CourtCourt of Appeals for the D.C. Circuit
DecidedOctober 12, 1942
Docket7929, 7930
StatusPublished
Cited by53 cases

This text of 130 F.2d 233 (American Medical Ass'n v. United States) is published on Counsel Stack Legal Research, covering Court of Appeals for the D.C. Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Medical Ass'n v. United States, 130 F.2d 233 (D.C. Cir. 1942).

Opinion

MILLER, Associate Justice.

In United States v. American Medical Association, 1 we held that the term “in restraint of trade” as used in Section 3 of the Sherman Act, 15 U.S.C.A. § 3, had its genesis in the common law; that the practice of medicine was recognized by the English cases as constituting trade; that a restraint imposed upon the practice of medicine may constitute a restraint of trade; that restraints imposed upon the operation of hospitals and upon Group Health Association, designed to prevent it from making available to and financing medical services on behalf of its members may constitute restraint of trade; that the indictment under which appellants were charged stated a case under Section 3 of the Sherman Act. Accordingly, we held that the indictment was sufficient as against a demurrer; we reversed a judgment of the District Court, which had sustained a demurrer, and remanded the case for trial.. Upon the trial which followed and at the close of the Government’s case the court directed verdicts of acquittal for two unincorporated associations and two individual defendants. Thereafter the jury convicted the appellants and acquitted all other defendants. Appeals from the judgment of the District Court, based upon these convictions, were consolidated for hearing in this court.

On this appeal it is suggested that the Supreme Court, in Apex Hosiery Co. v. Leader, 2 repudiated the doctrine stated in our earlier decision; hence that we should reconsider and abandon the position which we there took. But we see no reason to adopt the suggestion which, apparently, grew out of appellants’ failure to distinguish between trade and restraint of trade. Appellants’ confusion is evidenced by the following statement from their brief: “The Apex case held in substance and effect that no activity could be in ‘trade’ unless it was a commercial activity and exercised and used in such a way as to affect the market either by fixing prices or suppressing competition in the market to the injury of the public.” Of course the Court did not so hold, nor has any court ever so held. Most activities which are in trade serve, rather than injure, the public.

In the Apex case, 3 no question was involved as to whether the petitioner was engaged in trade or commerce. The opening sentence of the opinion states, as an undisputed fact: “Petitioner, a Pennsylvania corporation, is engaged in the manufacture, at its factory in Philadelphia, of hosiery, a substantial part of which is shipped in interstate commerce.” Neither was the Court in doubt as to whether trade or commerce was affected by the actions complained of. 4 The question which was presented for its *236 decision was whether the conduct of the labor union and its members constituted restraint of trade, within the meaning of Section 1 of the Sherman Act, 15 U.S.C.A. § 1. 5

In answering this question the Court, first, restated the familiar common law doctrines relating to contracts and combina-tions in restraint of trade and the equally familiar history of the taking over, by the Sherman Act, of the common law concept of illegal restraints. 6 It then concluded that (1) the Sherman Act does not condemn all combinations and conspiracies which interrupt interstate transportation; 7 (2) labor unions are to some extent and in some circumstances subject to the Act; 8 but (3) it does not apply to all labor union activities affecting interstate commerce; 9 (4) the evil at which the Sherman Act was aimed was the control of the market “by suppression of competition in the marketing of goods and services * * * ”; 10 (5) the end sought was the prevention of “restraints to free competition in business and commercial transactions which tended to restrict production, raise prices or otherwise control the market to the detriment of purchasers or consumers of goods and services * * *” 11 and, finally (6) “Restraints on competition or on the course of trade in the merchandising of articles moving in interstate commerce is not enough, unless the restraint is shown to have or is intended to have an effect upon prices in the market or otherwise to deprive purchasers or consumers of the advantages which they derive from free competition.” 12

The trade or commerce which was involved in the present case was of three kinds: (1) The making available and financing of medical and hospital services; (2) medical service itself, i.e., service rendered by medical doctors; (3) hospital service, Le., service rendered by hospital staffs and the use of hospital facilities. As we indicated in our earlier opinion the common law recognized the practice of medicine as being trade 13 and there is nothing in the Apex case to suggest the contrary. It may be regrettable that Congress chose to take over in the Sherman Act the common law concept of trade, at least to the extent of including therein the practice of medicine. Developments which have taken place during recent decades in the building up of standards of professional .education and licensure, together with self-imposed standards of discipline and professional ethics, have, in the belief of many persons, resulted in substantial differences between professional practices and the generally accepted methods of trade and business. As we pointed out in our earlier decision, 14 the American Medical Association and other local medical associations have undoubtedly made a pro *237 found contribution to this development. However, our task is not to legislate or declare policy in such matters but, rather, to interpret and apply standards and policies which have been declared by the legislature. That Congress did use the common law test there is no doubt. That Congress was not otherwise advised was perhaps because of the failure of the professional groups to insist upon the distinction and to secure its legislative recognition. In any event, there is no doubt that Group Health Association was engaged in trade or commerce, within the meaning of the applicable section of the statute. 15 It is not necessary, in order to constitute trade or business, that it shall be carried on for profit. 16 Appellants protest that the District Court has said in Group Health Association v. Moor : 17 “The actions of the plaintiff [G.H.A.] in no way tend to commercialize the practice of medicine.” They argue from this that the activities of Group Health Association were not commercial activities and hence not in trade within the meaning of the Sherman Act. But this argument misses the point.

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130 F.2d 233, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-medical-assn-v-united-states-cadc-1942.