Collusion among buyers is every bit as objectionable on social welfare grounds as collusion among sellers. In this chapter, we focus on the antitrust claims in Kamakahi v. American Society of Reproductive Medicine, which arose from collusion among buyers of human eggs (oocytes), which were comprised of fertility clinics and donor agencies. Two closely related trade associations organized and orchestrated a price-fixing conspiracy aimed at depressing the fees paid to egg donors. The antitrust victims were women who were underpaid for the eggs that they donated to fertility clinics or donor agencies. The collusion among fertility clinics would seem to warrant harsh treatment under Section 1 of the Sherman Act. While this case raises important issues in medicine, public health, eugenics, and ethics, we focus our analysis on the merits of the antitrust claim and the effect on the competitive process.

The United States has faced a significant and persistent nurse shortage. Usually, a shortage is remedied with increased prices (or wages), which would increase the number of nurses. But hospital administrators appear to be unwilling to raise salaries for nurses. Unfortunately, this means that patients may not receive the quality of care that a fully staffed hospital could provide. The exercise of monopsony power may be one explanation for the persistent shortage. Employers of nurses often have substantial monopsony power, which allows them to increase their profits by reducing the quantity of nurses they hire. Having and exercising monopsony power, however, is not per se illegal. In this chapter, we focus on a possible alternative explanation for the nursing shortage: collusive monopsony in the nurse labor market, behavior that is per se illegal. It occurs when firms conspire with one another to depress wages. Recent antitrust litigation in several states has indicated that there may be pervasive collusion and information sharing among hospitals aimed at depressing the salaries of nurses.