Document: 466 U.S. 2 104 S.Ct. 1551 80 L.Ed.2d JEFFERSON PARISH HOSPITAL DISTRICT NO. 2, et al., Petitionersv.Edwin G. HYDE. No. 82-1031. Argued Nov. 1983. Decided March 27, 1984. Syllabus A hospital governed by petitioners has a contract with firm of anesthesiologists requiring all anesthesiological services for the hospital's patients to be performed that firm. Because this contract, respondent anesthesiologist's application admission medical staff was denied. Respondent then commenced an action in Federal District Court, claiming exclusive violated § 1 Sherman Act, and seeking declaratory injunctive relief. The Court denied relief, finding anticompetitive consequences were minimal outweighed benefits form improved patient care. Appeals reversed, illegal "per se." court held case involved "tying arrangement" because users operating rooms (the tying product) compelled purchase chosen tied product), possessed sufficient market power coerce purchasers product, since product constituted "not insubstantial amount interstate commerce," arrangement therefore Held: question does not violate Act. Pp. 9-32. (a) Any inquiry into validity must focus on or markets which two products are sold, is where forcing its impact. Thus, analysis issue sale patients, rather than contractual arrangements providers services. In making analysis, consideration given whether selling separate may together, and, if so, they have used their force accept arrangement. 9-18. (b) No can exist here unless there demand from identify distinct it efficient offer separately fact requires would otherwise purchased make illegal. Only forced contracting firm's as result consequences. If no present, free enter competing use another anesthesiologist instead 18-25. (c) record provide basis applying per se rule against question. While such factors relied rendering decision—the prevalence health insurance eliminating patient's incentive compare costs, patients' lack information quality care provided hospitals—may generate "market power" some abstract sense, do kind justifies condemnation tying. Tying need only condemned restrain competition merits purchases made. price consciousness will them take whose want. Similarly, cannot evaluate services, follows indifferent between certified even absence 26-29. (d) order prevail liability, burden showing challenged Act unreasonably restrained competition, been evidence insufficient actually operates market, competition. All establishes choice at limited one four doctors who associated admitted staff, range enlarged, but most significant restraints freedom select specific nevertheless remain. There price, quality, supply either product" "tied adversely affected whole contract. 29-32. 686 F.2d 286, reversed remanded. Frank H. Easterbrook, Chicago, Ill., petitioners. Jerrold J. Ganzfried, Washington, D.C., amicus curiae. John M. Landis, New Orleans, La., respondent. Justice STEVENS delivered opinion Court. At anesthesiologists. We decide gives rise violation Act1 every undergoing surgery anesthesiologists, not, restrains among July 1977, Edwin Hyde, board anesthesiologist, applied East Jefferson Hospital. credentials committee executive recommended approval, party providing required Roux & Associates, professional corporation. judgment unlawful injunction ordering appoint him staff.2 After trial, 513 F.Supp. 532 (ED La.1981). persuaded 286 (5th Cir.1982). granted certiorari, --- ----, 103 1271, 75 493, now reverse. 3 * February 1971, shortly before Hospital opened, entered "Anesthesiology Agreement" Associates ("Roux"), had recently organized Dr. Kermit Roux. any designated staff. agreed space, equipment, maintenance, other supporting necessary operate anesthesiology department. It also drugs supplies. nursing personnel anesthesia department supplied hospital, right approve selection retention.3 "restrict [that] persons, parties entities shall perform within term contract." App. 19.4 4 1971 one-year automatically renewable successive periods elected terminate. 1976, second written executed containing provisions agreement. Its five years clause excluding deleted;5 continued regard itself committed closed permitted practice hospital. time trial included usually employed 13 14 registered nurse anesthetists.6 5 impact different segments economy: consumers consumer elects operation employ except those Jefferson. 6 least 20 hospitals Orleans metropolitan area about 70 cent living Parish go regarded entire relevant geographic compete, convinced possess power"; concluded could ends.7 same led draw conclusion. Noting 30 percent residents Hospital, "patients tend choose location quality," Bank Parish. conclusion buttressed facts eliminates sufficiently informed family convenience tends magnify importance location.8 7 involves "users service product)." F.2d, 289. Having defined Parish, "sufficient product." 291. Since under Appeals' reading our decision Northern Pac. R. Co. v. United States, 356 1, 11, 78 514, 521, 545 (1957), se."9 II 8 Certain types deemed unreasonable matter law.10 character restraint produced considered presuming unreasonableness without necessity context found.11 fixing agreement competitors classic example Arizona Maricopa County Medical Society, 457 332, 343-348, 102 2466, 2473-75, 73 48 (1982). far too late history antitrust jurisprudence proposition certain pose unacceptable risk stifling se."12 first enunciated International Salt 332 392, 396, 68 12, 15, 92 L.Ed. (1947),13 endorsed many times since.14 reflects congressional policies underlying laws. enacting Clayton 15 U.S.C. 14, Congress expressed great concern arrangements. See H.R.Rep. 63-627, 63d Cong., 2d Sess., 10-13 (1914); Sen.Rep. 63-698, 63rd 6-9 (1914).15 arise made therein concerning competitive illuminating, respected.16 9 clear, however, refusal sell said each seller's single package imposes particularly suppliers several parts.17 For example, we "if dozen food stores community refuse flour buyer took sugar hardly ready able itself." 7, 519, (1958).18 Buyers often find sales attractive; packages merely attempt compete effectively—conduct entirely consistent Fortner Enterprises States Steel Corp. (Fortner I), 394 495, 517-518, 89 1252, 1265-66, 22 495 (1969) (WHITE, J., dissenting); id., 524-525, S.Ct., 1269-70 (Fortas, dissenting). 10 Our cases essential characteristic invalid lies exploitation control over did want all, might preferred elsewhere terms. When "forcing" item violated. 11 "Basic faith economy best promotes public weal goods stand cold test competition; public, acting through market's impersonal judgment, allocate Nation's resources thus direct course economic development take. . By conditioning his commodity another, seller coerces abdication buyers' independent 'tied' product's insulates stresses open market. But intrinsic superiority convince freely choosing buyers others anyway." Times-Picayune Publishing 345 594, 605, 872, 878, 97 1277 (1953) (footnote omitted).19 12 Accordingly, when special ability—usually called power"—to purchaser something he II), 429 610, 620, 861, 867-68, 51 (1977); I, U.S., 503-504, 1258-59; Loew's Inc., 371 38, 45, 48, n. 5, 83 97, 102, 103, (1962); 6-7, 518-19, (1956).20 occurs, found unlawful. law draws distinction enhancing hand, attempting impose other. just maximize return presumably enjoys justifiable advantage competitors, ideal necessarily compromised. impair potentially inferior insulated pressures.21 This impairment harm existing create barriers entry new 509, 1261-62,22 increase social costs facilitating discrimination, thereby increasing monopoly profits what absent tie, II, 617, 866.23 And standpoint consumer—whose interests statute especially intended serve—the bargain impaired perhaps inability true cost available package.24 sum, permit be, observed condone "the existence tolerate." 866 omitted). Per condemnation—condemnation actual conditions—is appropriate probable.25 focuses probability Of course, threshold substantial potential justify condemnation. "forced" respect item, resultant warrant law. reason refused condemn volume commerce foreclosed thereby. 501-502, 1257-58; (1956); Times-Picayune, 608-610, 880-81; Salt, 15. buy bought adverse portion sellers foreclosed. Once surmounted, prohibition likely. government patent similar fair presume power. 45-47, 102-03, (1962). effort enlarge scope using confers undermine lease patented condition patentee Paramount Pictures, 334 131, 156-159, 915, 928-30, 1260 (1948); 395-396, 14-15; Business Machines 298 56 701, 1085 (1936). 16 strict situations probable. share high, see 611-613, 881-82, (1953), offers unique offer, 504-506 1259-60 likelihood exists being appropriate. railroad's vast tracts western real estate, although unlawful, gave railroad bargaining enabled tie land exclusive, long commitments fenced out transportation protracted period.26 When, degree enables customers second, unwanted obtain established 499-500, 1256-57; 614-615, 883-84, (1953). 17 consider III 18 includes facilities variety surgical operations.27 anesthesiologist.28 Petitioners argue involve all—that functionally integrated services.29 Therefore, contend inappropriate apply principles case. 19 indicate, answer turns functional relation them, items.30 present link distinguishable eyes buyers.31 involving transactions, priced buyer's perspective, arrangement.32 These clear linked. requirement rationale definitional depends type addressed rule.33 utilized based possibility effect tying—that item.34 services.35 21 Unquestionably, component offered selected individual insist including customers. As practice, billed provide. ample uncontroverted testimony surgeons request come anesthesia, frequent respondent's specialty, obstetric anesthesiology.36 "[t]he provision hospital." F.Supp., 540.37 finding, went observe "an normally surgeon, patient, familiarity gained working relationship. Obviously, gain Associates." 291.38 amply supports differentiate petitioners.39 combined transaction.40 Nevertheless, noted above, nothing inherently packaged sales. Roux's Roux.41 petitioners' items beginning inquiry.42 IV 23 remains purchase. Respondent's invoking avoiding conditions relying preference persons residing Jefferson, closest kind, probative 24 Seventy 539. Thus Jefferson's "dominance" overwhelming.43 majority parish's elect means data establish dominant position obviates further conditions. acknowledged much; recognized alone infer power, imperfections"44 charge noncompetitive prices services: third payment reduces adequate renders unable hospitals. 290.45 these sense,46 25 forcing. consciousness, want—their indifference willingness ability utilize choice. anesthesioligists arrangement—such "on merits." 26 neither imperfections" upon forces tie. safe assume needs anesthesiologist; contains unwilling patients.47 V 27 proving That takes place defined. offering patients; encompass contracts statewide local.48 is, sheds little light how anesthesiologist.49 indicates Roux, sophisticated enough know difference choice.50 28 privileges.51 Even alternatives severely nature transaction unquestioned exercise identity number whom accords privileges. enlarged doctors, remain.52 Without laws, VI 29 Petitioners' policy raise questions ethics,53 inconvenienced prefer administered someone member obviously characterized branded well Hyde elsewhere, Indeed, previously noted, tells us very Yet principal simply prohibited remanded proceedings opinion.54 so ordered. 31 BRENNAN, MARSHALL joins, concurring. 32 demonstrates, subject evaluation illegality Whatever merit arguments longstanding construction have, Congress, aware decisions, never changed amending circumstances, settled statutory interpretation leave task modifying statute's reach Congress. Monsanto Spray-Rite Service Corp., (1984) (BRENNAN, concurring). I depart principle join 33 O'CONNOR, Chief BURGER, POWELL, REHNQUIST join, concurring judgment. 34 Petitioner, authorized administer tie-in concur Court's reverse write explain why believe Hospital-Roux treated effecting dealing properly analyzed Rule Reason. 35 marketing insists package. supermarket engaged Flour referred product. allegation unlawfully general room service) anesthesiologists' services). occasion actions alleging (1947). 36 Under usual logic rule, trade rarely serves purposes proof anti-competitive effect. See, e.g., Pacific 518, (1958). deciding should declared se, severity [is] balanced pro-competitive Cases fit generalization arise, common important expense them." Continental T.V., Inc. GTE Sylvania 433 36, 50 16, 2549, 2557 53 568 (1977). 351, 2477, loss society banning altogether unnecessary. 37 Some earlier indeed declare serve "hardly purpose beyond suppression competition." Standard Oil California 337 293, 305-306, 69 1051, 1058, 93 1371 (1949) (dictum). However, declaration taken literally purported rely it. shown appreciably ." Co., supra, 6, 518. "control dominance product," effectual weapon pressure taking item," "insignificant." Ibid. willing say arrangements, price-fixing, division agreements always illegal, 38 se" doctrine elaborate effects arrangement.1 result, incurs approach achieving benefits: calls extensive time-consuming reason, interpreted prohibit show beneficial. Moreover, label generated more confusion coherent appears invite lower courts omit circumstances element analysis. 39 abandon refocus effects, benefits, have. tie-ins brought accord applicable allegedly few horizontal quasi-horizontal justification whatsoever.2 change rationalize already applied. 40 prior opinions indicate demonstrable exclusionary 878-79, abet harmful possesses market.3 disapproved instances. 41 Market acquired legitimately (e.g., grant patent) illegitimately monopolization). event, regulated reference developed. profit extract flour, along flour. Counterintuitive though assertion seem, easily demonstrated widely accepted. Bork, Antitrust Paradox 372-374 (1978); P. Areeda, Analysis 735 (3d ed. 1981). 42 economically primarily rare additional product.4 concerned when, monopolist threatens acquire driving sugar, difficult extension unlikely, poses threat harm, satisfy three criteria.5 43 First, market.6 Absent conceivably tied-product market.7 none insisting well. Enterprises, 867, (1977) ("Fortner II"); 1258-59, I"); 103-04 518-19. 44 Second, occupied stable likely driven tying, low. If, active vibrant sugar—one numerous deal flour—the monopolist's Cf. 617-618 8, 866-67 8; 498-499, 611, 881-82; 1058; erect suspect. Atlantic Refining Trade Commission, 381 357, 371, 85 1498, 1507, 443 (1965). 45 Third, treating distinct. simplest broken down components together" final sale. Unless cars engines cameras lenses, guided limiting principle. distinct, must, minimum, wish purchasing product.8 conjunction together. useless projected sold together; exploit tie.9 monopolize produce distribute cheaply sellers. unusual case, monopolized useful suffer injury monopolization 46 makes sense considering justifications unit. advantages joint packaging appropriately viewed products, end inquiry. largely adopted approach.10 Foster Maryland State Savings Loan Ass'n, 590 928, 930-933 (CADC 1978), cert. denied, 439 1071, 99 842, 59 (1979); Response Carolina, Leasco Response, 537 1307, 1330 (CA5 1976); Kugler AAMCO Automatic Transmissions, 460 1214 (CA8 1972); ILC Peripherals Leasing 448 228, 230 (N.D.Cal.1978); Electronics 187 545, 563 (E.D.Pa.1960), aff'd curiam, 365 567, 81 755, 806 (1961). 47 conditions—market distinct—are requirements. Reason prove acceptable met. Tie-ins entail harms, requirements met balance. "Tie-ins facilitate fields wedded ties habit custom. Brown Shoe 370 294, 330 [82 1502, 1526-27, 510] They clandestine cutting fear retaliation producers protect reputation failure cause misfunction. [citing Pick Mfg. General Motors 641 (CA 1935), aff'd, 299 3, 57 L.Ed (1936) ] And, related, reduce economies production distribution." 514 9, 1264 (Justice WHITE, 49 ultimate laws depend may, innocuous exploits "force" exerts raising Markovits, Tie-Ins, Reciprocity Leverage Theory, 76 Yale L.J. 1397, 1397-1398 (1967); Burstein, Theory Full-Line Forcing, 55 Nw.U.L.Rev. 62, 62-63 (1960). On efficient. outweighs contribution efficiency. Application criteria hand straightforward. Although doubt, area. contrary, 541, determined appellate defer findings fact-bound questions,11 discussion determination local 52 Hospital's presumed drive anesthesiology: narrowly defined, auspices. giving closer scrutiny satisfied here: sound Patients interested services,12 affect nor become patients. probably purposes. 54 are, absolute inevitable consequence undergo receiving anesthesia. side balance, found, dispute, conferred served. improves permits ways. From viewpoint management, ensures hour coverage, aids standardization procedures facilitates flexible scheduling operations, effectively monitor Further, advantageous because, places responsibility physician assumes available, suitable patient. assuming responsibilities—responsibilities seriously ill frequently discharge provides valuable indication dissatisfied wished enjoy employed. Given effectiveness department, surprising that, accepted industry generally. Such arrangement, achieves condemn.13 reaffirms require Whether unquestionably constitute dealing. Exclusive independently Tampa Electric Nashville Coal 320, 333-335, 623, 631-32, 580 competes area, grounds complain stifles adverse, albeit indirect, welfare 58 extend supplier allowing deprive goods, needed source supply. determining unreasonable, proper structure question—the business, ease redirect others. fraction frozen deal. (1949). mobile, large, narrow To substantially procompetitive ensuring encouraging term, mutually business relationships. relatively small suggestion "bottleneck" availability access associates narrowed choices search Contrast Associated Press 326 65 1416, 2013 (1945). represents total hire hospitals, buying engaging detailed size readily conclude enhance relative sustained 60 reasons products. possible possess. together sufficient, standing alone, insulate attack service. 61 Plainly, forecloses still smaller secure survives 62 Fifth Circuit remaining claims. Opinion ante, 2. Section states: "Every combination trust otherwise, conspiracy, foreign nations, 1. enforce virtue addition relief complaint alleged violations 1983 state rejected passed claim. physicians confine Originally full committee. furnish necessary. designate qualified head fees cover deduction eight reserve uncollectible accounts, divided equally "Roux testified requested omission language 1976 believes surgeon entitled He group work outside following felt changes it." 537. Approximately 875 operations month; time. found: "The resulting minimal. restricted twenty situation pointed plaintiff, privileges option admitting Similarly Jefferson." 541. discuss Louisiana 156 rooms. tell "open" departments departments. Respondent, practices department; practiced Florida. shortage surplus part country, thriving starving. "clearly erroneous" justified considerations. 292. "For charges defendants fixing, concertedly non-members association, licensed device unpatented materials device, immaterial Columbia 522-523, 1107, 1121-22, 1533 (1948). Sylvania, 49-50, 2557, intimated liability profession. 543-544. approach. 292-294. "assume" trades businesses. Brief 4, generally National Soc. Professional Engineers 435 679, 98 1355, 637 (1978). roots date Motion Picture Patents Universal Film 243 502, 416, 871 (1917), holding film projector conditioned patentee's films, extending monopoly. Henry Dick 224 70-73, 364, 387-89, 645 (1912) (White, C.J., 619-621, 1256, (1969); White Motor 372 253, 262 696, 738 (1963); 330, 82 510 (1958); Black Magnolia Liquor 355 24, 25, 106, 108, (1957); 608-609, 880-81, (1953); Cong.Rec. 9072 (1914) (remarks Rep. Webb); 9084 Madden); 9090 Mitchell); 9160-9164 Floyd); 9184-9185 Helvering); 9409 Gardner); 9410 9553-9554 Barkley); 14091-14097 Sen. Reed); 14094 Walsh); 14209 Shields); 14226 14268 14599 White); 15991 Martine); 16146 Spivack, Chicago School Approach Single Firm Exercises Monopoly Power: 651, 664-665 (1984). House Report stated: pay higher put inconvenience securing commodities communities mail-order houses procured Where powerful, Machinery American Tobacco 'tying' dealers becomes greatest agencies instrumentalities ever devised brain man. completely shuts engaged, opportunities build up powerful combinations system practice. method built owns controls machinery shoe-manufacturing States. manufacturer shoe machines slightest opportunity considerable country while obtains. machine manufactured company establishment, withdraw establishment wreck manufacturer. system, practically destroyed virtual films consumer, dealer worse system." 12-13 (1914). Mitchell "monopoly get machines, all. Independent companies sought field preempted manufacturers break giant monopolies, install machinery, jeopardized leased monopolies removed business. cries urgently situation, bill seeks prevent monopoly, alike injurious dealers, manufacturers, grossly unfair seek millions consumers." generally, Hodel Virginia Surface Mining Recl. Assn., 452 264, 276-277, 101 2352, 2360-61, (1981); Dukes, 427 297, 303-304, 96 2513, 2516-17, 511 (1976) (per curiam ). "Of problem unit price." credit way proves cheap financing expensive houses." 622, 868, Accord, 508-509, 1261; FTC, 369-371, 1506-07, (1965); 44-45 WHITE written: "There commentators fundamental proscription meant guard attain distort distortion injures brand artificially less optimal second. customer brands loses agreeing first, toward firms prepared match offset attraction itself. simultaneous both significantly simple shifting habits considerably cumbersome responsive variations offers. evade transfer product; counting discrimination; line line." 512-514, 1263-64 (dissenting opinion) (footnotes sometimes "leverage." Professors Areeda Turner definition suits " 'Leverage' loosely supplier's induce solely D. Turner, Law ¶ 1134a 202 (1980). Attorney General's Committee Study Laws 145 (1955); Craswell, Requirements Competitive Markets: Consumer Protection Issues, B.U.L.Rev. 661, 666-668 (1982); Slawson, Stronger, Simpler Tie-In Doctrine, Bull. 671, 676-684 (1980); Validity Arrangements Laws, 72 Harv.L.Rev. 50, 60-62 20, 733e; C. Kaysen Policy 157 (1959); L. Sullivan, O. Williamson, Markets Hierarchies: Implications 111 (1975); Pearson, Policy, 626, 637-638 Sales measure item; greater larger item. 533 (1974); Posner, 173-180 (1976); 22, 156; Bowman, Problem, 67 (1960); Dam, Steel: "Neither Borrower Nor Lender Be", 1969 Sup.Ct.Rev. 15-16; Ferguson, Reciprocity: An Economic Analysis, Contemp.Probs. 552, 554-558 Reciprocity, (Part 1397 647-653; Sidak, Debunking Predatory Innovation, Colum.L.Rev. 1121, 1127-1131 (1983); Stigler, Inc.: Note Block Booking, 1963 152. Especially imperfections exist, fully sensitive implications hence impede merits. 21, 675-679. rules avoid burdensome conduct render unjustified particular bar conduct. 350-351, 2476-77, "As before, defendant initially large acreages Northwestern lines run. strategically located checkerboard fashion amid private holdings distance facilities. Not various witnesses evident prized activities. disposing covering million acres 'preferential routing' clauses. host compelling defendant's where, here, explanation restraints. clauses benefit lessees. got wanted yielding carriers, claim came cheaper restrictive omitted. reduction rail shipments quite plainly rebate shipper. So Railroad fence stifle Id., 7-8, 519-20 physical include room, recovery stays after operation. physicians, radiologists pathologists, interns, nurses, dietitians, pharmacists laboratory technicians. legality whereby supplies raises question, 51, infra. insistence creates Dolan Ralston, Admitting Privileges Hous.L.Rev. 707, 756-758 Kissam, Webber, Bigus Holzgraefe, Privileges: Testing Conventional Wisdom, Calif.L.Rev. 595, 666-667 linked remove realm devices. Mercoid Mid-Continent 320 64 268, 88 376 (1944) (heating stoker switch); Morton Suppiger 314 488, 402, 86 363 (1942) (salt salt); supra (same); Leitch Barber 302 458, 288, (1938) (process material process); (computer computer punch cards); Carbice Am. 283 334, 819 (1931) (ice cream coolant); FTC Sinclair 261 463, 450, 746 (1923) (gasoline underground tanks pumps); Mach. 258 451, 363, 66 708 (1921) (shoe supplies, peripheral machinery); 558-560 Pa.1960) (components television antennas), (1961) fact, enable charging rent user 23, supra. newspapers, published ownership control. readers consciously distinguished publications imply advertisers insertions placed speculation space motivated considerations coverage; media selections, effect, rested generic qualities differentiating morning evening Orleans. advertising sole daily, doubtless blanket coverage newspaper readership, suggests city's readers, evening, fungible potential. assume, therefore, readership 'bought' selfsame 'product' matter, Item. factual departure manifest. core adjudicated desired Here, newspapers place, time, terms indistinguishable advertisers; (in other); leverage excludes identical same." 613-614, 883 outset familiar involved. seller, corporation, much paid inseparable pass arises. cry corporation borrower sum money above purchased. standards exactly 'single product,' 507, 1260-1261 Professor Dam "[T]he hard harmful. adopting flee ruling presumptively harmful, whenever nominal foreclosure weakness methodology crucial falls limits, heard. defining treat compound approach." 19. "tying," prohibits "contracts trade." "tying" beside point. consequences, labeled "tying." addressed, irrespective label. courts. Moore Jas. Matthews 550 1207, 1214-1215 (9th Cir.1977); Siegel Chicken Delight, 43, 48-49 Cir.1971), 405 955, 1172, 232 (1972); Washington Gas Light Power 438 248, 253 (4th Cir.1971); Susser Carvel 505, (2d Cir.1964), dismissed, 125, 1364, 284 Mercedes-Benz North America, 517 1369, 1379-1381 (ND Cal.1981); re Data Litigation, 490 1089, 1104-1110 Cal.1980); Jones 247 Chestnut Properties, 1975-2 CCH Cas. 60,491, 67, 162-67,163 Ill.1974); N.W. Controls, Outboard Marine 333 501-504 (D Del.1971); Teleflex Industrial Products, Brunswick 293 107, 109 Pa.1968). Ross, Product Issue Tying: Functional Approach, Emory 963 Wheeler, Observations Tie-ins, Single-Product Defense, Dealing Regulated Industries, 1557, 1558-1567, 1572-1573 Note, Separability: Workable Identify S.Cal.L.Rev. 160 (1972). 525, 1269-1270 Issue, Ohio St.L.J. 861 (1970). Testimony Tr. 17, (May 1980, afternoon session), 68-69, 72-74 1980), well, 64, 87-88 1980) (testimony Charles Eckert); 25-30, 33-34 Adriani). decisions. statistical financial relationships Association, Socioeconomic Characteristics Practice: (1983). differ radiologists, hospital-based (HBPs). "In respects akin office-based MDs (particularly surgeons) HBPs. Anesthesiologists' outputs discrete, HBPs predominantly fee-for-service practitioners directly patients." Steinwald, Hospital-Based Physicians: Current Issues Descriptive Evidence, Health Care Financing Rev. 63, (Summer 1980). Society Anesthesiologists, 473 147, 150 (SDNY 1979) ("By 1957 salaried exception. Anesthesiologists began clinicians"). conclusions 542. challenge Appeals. One cited statements Judge Van Dusen Pa.1960), statement specifically statutes same. 880-881. presented antenna Others equipment complete gear exclusively Jerrold. pieces varied versions Furthermore, charged lump payment. Finally, cable antennas concerns, electronic 559. shows separately, precisely same, objection here. permissible 555-558. Assuming defense exists, give uncertain future, inapplicable continue grocer carry cookies more. wants fifth brand, sue town. food. (1958) (grocer itself"). examination law, doctor hours, son-in-law administrator violating view restraining whatever creation. Conversely, evidence, apply. reject improving 24-hour scheduling, routine, maintenance equipment. clearly erroneous achieve ends. ensure comply demands standards. past, tolerate manifestly 348-351, 2475-2477, Gerimedical Blue Cross, 378, 2415, Assn. 317 528-529, 63 326, 328-329, 87 434 (1943). solicitude. uniformly "goodwill" defenses specifications (1949); 397-398, 15-16, (1947); 138-140, 704-705, Comment, Laws: "Integrity Product" Mich.L.Rev. 1413 (1964). departing dissimilar inferring 881-883. contexts shares comparable Connecticut Bank, 418 656, 94 2788, 1016 Du Pont 351 377, 994, 100 (1956). imperfections, truly appellant failed arrangement." 290. exist. 388 13, 391-393 18, 2421 2423-2424 §§ 300k, 300k-2(b) (1976 Supp. V); Conf.Rep. 420, 96th 1st 57-58 96, 52-53 (1979), U.S.Code Cong. Admin.News 1979, 1306. raised levels 867-868; 1258-1259. respondents' increased fixed discrimination. variable-quantity unavailable seen condemning 15-17; 67-72. like unlikely enabling "to 513, Insurance industry; limitations Through obtaining anesthesioligists' realize security occurred anesthetists profits, equal frequency 537, 543. details enhanced value harmed impressionistic tended discourage young entering equivocal contract's barriers. press point capital run hospital-wide contractor appear present. impeded, empirical demonstration reveals anything likely, selects has, competitors. Like penetration (1961); attempted showing. lead complaints contention self interest ethical norms operates, Joint Commission Accreditation Hospitals, Manual Hospitals 3-10, 151-154 Amicus Curiae A. claims remain remand. analyzing prima facie affirmative defenses. Most notably, 559-560 (1961), upheld systems installation repair service, assured protected reputation. anomalous reason. subjects restrictions franchisee's searching Compare, (CA9 1971), (1972), contracts, tie-ins, infra, 44-45. note 4. undesirable instances, one. super-competitive lacks unregulated, 1263-1264, help engage discrimination "metering" (1936); Price 13. decrease 398; 608-610; 11-13 (1975). 866, (1977), "), hold harmful; indicated address facilitated herein aimed alleged. Wholly apart characteristics, prerequisite commerce. McLain Real Estate Board 444 232, 246, 511, 441 Burke Ford, 389 322, 443, 444, 554 (1967). disputed past define necessary, resolve assumed tendency accomplishment monopoly." next "dominance," 610-613, 881-883, careful Then, 519-520, (1958), More recently, conducted profitability tie—the affected, misconception copyright, high share, suffice demonstrate power: holder close substitutes reasonable Landes Cases, 937 (1981). presumption support cases. (1948), "block booking" motion pictures, rights copyrighted pictures copyrightholder, analyze schema Rather, borrowed "patent misuse," prevents 928-930. Investment 665, 271, (1944). misuse" influenced strike cite irrelevant. conceded non-competitive chooses P 735; 963, 1010 19, 21-23 (1957). occasional references problem. heretofore set forth apparently newspaper—access respective newspapers—because subscribers distinguish papers. 613-616, 883-884. reversing summary extended. 506-507, 1260-1261. disclaimed 1261. mere conventional separability determine Fed.Rules Civ.Proc. 52(a); Inwood Laboratories, Ives 456 844, 855-858, 2182, 2188-2190, 606 devoid assumption one, certainly finds contradiction record. disregarded them. expect tie-in,

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