IDEAS home Printed from https://ideas.repec.org/a/aea/aecrev/v100y2010i4p1399-1431.html

Are Health Insurance Markets Competitive?

Author

Listed:
  • Leemore S. Dafny

Abstract

To gauge the competitiveness of the group health insurance industry, I investigate whether health insurers charge higher premiums, ceteris paribus, to more profitable firms. Such "direct price discrimination" is feasible only in imperfectly competitive settings. Using a proprietary national database of health plans offered by a sample of large, multisite firms from 1998-2005, I find firms with positive profit shocks subsequently face higher premium growth, even for the same health plans. Moreover, within a given firm, those sites located in concentrated insurance markets experience the greatest premium increases. The findings suggest health care insurers are exercising market power in an increasing number of geographic markets. (JEL G22, I11, I18, L11, L25)

Suggested Citation

  • Leemore S. Dafny, 2010. "Are Health Insurance Markets Competitive?," American Economic Review, American Economic Association, vol. 100(4), pages 1399-1431, September.
    • Handle: RePEc:aea:aecrev:v:100:y:2010:i:4:p:1399-1431
    Note: DOI: 10.1257/aer.100.4.1399
    as

    Download full text from publisher

    File URL: http://www.aeaweb.org/articles.php?doi=10.1257/aer.100.4.1399
    Download Restriction: no
    File URL: http://www.aeaweb.org/aer/data/sept2010/20080356_data.zip
    Download Restriction: no
    File URL: http://www.aeaweb.org/aer/data/sept2010/20080356_app.pdf
    Download Restriction: Access to full text is restricted to AEA members and institutional subscribers.
    ---><---

    References listed on IDEAS

    as
    1. David G. Blanchflower & Andrew J. Oswald & Peter Sanfey, 1996. "Wages, Profits, and Rent-Sharing," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(1), pages 227-251.
    2. Blundell,Richard & Newey,Whitney K. & Persson,Torsten (ed.), 2006. "Advances in Economics and Econometrics," Cambridge Books, Cambridge University Press, number 9780521871525.
    3. Baltagi, Badi H. & Wu, Ping X., 1999. "Unequally Spaced Panel Data Regressions With Ar(1) Disturbances," Econometric Theory, Cambridge University Press, vol. 15(6), pages 814-823, December.
    4. Blundell,Richard & Newey,Whitney K. & Persson,Torsten (ed.), 2006. "Advances in Economics and Econometrics," Cambridge Books, Cambridge University Press, number 9780521692083.
    5. Severin Borenstein & Joseph Farrell, 2007. "Do investors forecast fat firms? Evidence from the gold-mining industry," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 626-647, September.
    6. Duggan, Mark, 2004. "Does contracting out increase the efficiency of government programs? Evidence from Medicaid HMOs," Journal of Public Economics, Elsevier, vol. 88(12), pages 2549-2572, December.
    7. Gruber, Jonathan & Washington, Ebonya, 2005. "Subsidies to employee health insurance premiums and the health insurance market," Journal of Health Economics, Elsevier, vol. 24(2), pages 253-276, March.
    8. David Dranove & Anne Gron & Michael J. Mazzeo, 2003. "Differentiation and Competition in HMO Markets," Journal of Industrial Economics, Wiley Blackwell, vol. 51(4), pages 433-454, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Leemore Dafny, 2008. "Are Health Insurance Markets Competitive?," NBER Working Papers 14572, National Bureau of Economic Research, Inc.
    2. Alessia Matano & Paolo Naticchioni, 2011. "Is There Rent Sharing in Italy? Evidence from Employer-Employee Data," European Journal of Comparative Economics, Cattaneo University (LIUC), vol. 8(2), pages 265-279, December.
    3. Kocherlakota, Narayana & Phelan, Christopher, 2009. "On the robustness of laissez-faire," Journal of Economic Theory, Elsevier, vol. 144(6), pages 2372-2387, November.
    4. Schlatterer, Markus & Saur, Marc & Schmitt, Stefanie, 2019. "Horizontal product differentiation with limited attentive consumers," VfS Annual Conference 2019 (Leipzig): 30 Years after the Fall of the Berlin Wall - Democracy and Market Economy 203571, Verein für Socialpolitik / German Economic Association.
    5. Michel, Christian, 2017. "Market regulation of voluntary add-on contracts," International Journal of Industrial Organization, Elsevier, vol. 54(C), pages 239-268.
    6. Massimiliano Landi & Antonio Merlo & Vincenzo Galasso & Andrea Mattozzi, 2008. "The Labor Market of Italian Politicians," Labor Economics Working Papers 22461, East Asian Bureau of Economic Research.
    7. León, Gianmarco, 2017. "Turnout, political preferences and information: Experimental evidence from Peru," Journal of Development Economics, Elsevier, vol. 127(C), pages 56-71.
    8. Luís Cabral, 2018. "We’re Number 1: Price Wars for Market Share Leadership," Management Science, INFORMS, vol. 64(5), pages 2013-2030, May.
    9. Crescenzi, Riccardo & Nathan, Max & Rodríguez-Pose, Andrés, 2016. "Do inventors talk to strangers? On proximity and collaborative knowledge creation," Research Policy, Elsevier, vol. 45(1), pages 177-194.
    10. Per Krusell & Anthony Smith & Joachim Hubmer, 2015. "The historical evolution of the wealth distribution: A quantitative-theoretic investigation," 2015 Meeting Papers 1406, Society for Economic Dynamics.
    11. Jentzsch, Nicola & Sapi, Geza & Suleymanova, Irina, 2013. "Targeted pricing and customer data sharing among rivals," International Journal of Industrial Organization, Elsevier, vol. 31(2), pages 131-144.
    12. Susan Athey & Glenn Ellison, 2014. "Dynamics of Open Source Movements," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 23(2), pages 294-316, June.
    13. Mayer, Adalbert & Puller, Steven L., 2008. "The old boy (and girl) network: Social network formation on university campuses," Journal of Public Economics, Elsevier, vol. 92(1-2), pages 329-347, February.
    14. Davis, John B., 2010. "Neuroeconomics: Constructing identity," Journal of Economic Behavior & Organization, Elsevier, vol. 76(3), pages 574-583, December.
    15. Stefano DellaVigna, 2009. "Psychology and Economics: Evidence from the Field," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 315-372, June.
    16. Matzke, Christina & Wirth, Benedikt, 2008. "A non-standard approach to a market with boundedly rational consumers and strategic firms. Part I: A microfoundation for the evolution of sales," Bonn Econ Discussion Papers 10/2008, University of Bonn, Bonn Graduate School of Economics (BGSE).
    17. Pramila Krishnan & Emanuela Sciubba, 2009. "Links and Architecture in Village Networks," Economic Journal, Royal Economic Society, vol. 119(537), pages 917-949, April.
    18. Sugden, Robert, 2009. "Market simulation and the provision of public goods: A non-paternalistic response to anomalies in environmental evaluation," Journal of Environmental Economics and Management, Elsevier, vol. 57(1), pages 87-103, January.
    19. Colombo, Stefano, 2009. "On the effects of selective below-cost pricing in a vertical differentiation model," Economics - The Open-Access, Open-Assessment E-Journal (2007-2020), Kiel Institute for the World Economy, vol. 3, pages 1-13.

    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • L25 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Performance

    Lists

    This item is featured on the following reading lists, Wikipedia, or ReplicationWiki pages:
    1. Are Health Insurance Markets Competitive? (AER 2010) in ReplicationWiki

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aea:aecrev:v:100:y:2010:i:4:p:1399-1431. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Michael P. Albert (email available below). General contact details of provider: https://edirc.repec.org/data/aeaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.