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Sisters of Providence in Washington v. A.A. Pain Clinic12/19/2003
"the failure to pinpoint precisely the relevant market through detailed market analysis is not uniformly fatal to a claim under Sherman Act ยง 1."
Furthermore, Chandler presented statistical evidence describing the market at trial. Chandler's estimates that around sixty to sixty-five percent of hospital patients in Anchorage "run through Providence" were corroborated by statistical data published by the Department of Health and Social Services and by Providence. Though much of this evidence only considers hospital in-patients, Chandler testified that Providence retains a similar market percentage in out-patient services. We believe that a reasonable juror could conclude that this evidence demonstrates Providence's powerful position in the Anchorage area pain management market.
Providence and the Group next argue that Chandler failed to present any evidence that Providence and the Group entered into an agreement whose object was to harm or restrain competition. They point out that simple competitive desires to maximize profits at the expense of rivals, to even drive competitors out of business, are not objective bases upon which antitrust liability may be found.
As Professors Areeda and Hovenkamp note in their treatise on antitrust law, proving a conspiracy intended to harm competition is complicated by certain features inherent in any restraint of trade agreement: (1) conspirators will seldom admit to their unlawful agreement; (2) "behavior can sometimes be coordinated without any communications or other observable and reprehensible behavior"; and (3) the causal connection between observable acts and subsequent corroborating acts may be obscure. Thus, courts will often have before them agreements which on their face offer legitimate and lawful profit-seeking motives. Because of this, courts must look deeper to the longer term effects of the agreement to discover whether it is intended to harm competition:
It is not the form of the combination or the particular means used but the result to be achieved that the statute condemns. It is not of importance whether the means used to accomplish the unlawful objective are in themselves lawful or unlawful. Acts done to give effect to the conspiracy may be in themselves wholly innocent acts. Yet, if they are part of the sum of the acts which are relied upon to effectuate the conspiracy which the statute forbids, they come within its prohibition.
Because of the difficulty of proving intent, as well as the necessity of considering the long-term effects of a defendant's behavior, it would be natural to conclude then that proof of intent and proof of injury are closely related, and that the latter is inferential proof of the former. Professors Areeda and Hovenkamp reach just this conclusion:
It is often said that agreements do not offend the Sherman Act in the absence of a purpose or effect to restrain trade, or that a restraining agreement may be redeemed by a legitimate purpose. Such statements seem to call for inquiry into a defendant's state of mind. That inquiry often seems to invite the parties to examine thousands of documents, to depose nearly everyone, to resist early disposition on the ground that disputed intent requires trial, to burden the judge and jury with ambiguous evidence, and to invite decision on the basis of relative purity of heart rather than competitive impact.
These problems cannot be entirely avoided, because mental state is sometimes relevant, particularly when conduct is ambiguous. However, intent seldom determines reasonableness. Indeed, intent is often superfluous to the analysis of reasonableness, for it adds nothing to the conduct from which it is usually infer
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