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La integración vertical en el sistema de salud colombiano

Author

Listed:
  • Jairo Humberto Restrepo

    () (Universidad de Antioquia)

  • John Fernando Lopera

    () (Universidad de Antioquia)

  • Sandra Milena Rodríguez

    () (Universidad del Norte)

Abstract

Vertical integration in the health sector refers to the government structure designed to coordinate and control attention services in the different states of the value chain, and to facilitate the collaboration and communication between the suppliers. In Colombia, the vertical integration allows insurers (EPS) to provide health services directly through their own centers of attention (IPS). This situation has motivated the EPS to create their own IPS and other modalities of vertical integration or control. This article offers a model of double marginalization for only one EPS and one IPS, and concludes that when the insurance company practices vertical control toward the lender, the benefits are larger than in a scheme of independent firms; also, the final price of the integrated scheme is smaller.

Suggested Citation

  • Jairo Humberto Restrepo & John Fernando Lopera & Sandra Milena Rodríguez, 2007. "La integración vertical en el sistema de salud colombiano," Revista de Economía Institucional, Universidad Externado de Colombia - Facultad de Economía, vol. 9(17), pages 279-308, July-Dece.
  • Handle: RePEc:rei:ecoins:v:9:y:2007:i:17:p:279-308
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    File URL: http://www.uexternado.edu.co/facecono/ecoinstitucional/workingpapers/jrestrepo17.pdf
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    References listed on IDEAS

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    1. Hart, Oliver & Moore, John, 1990. "Property Rights and the Nature of the Firm," Journal of Political Economy, University of Chicago Press, vol. 98(6), pages 1119-1158, December.
    2. Gaynor, Martin, 2006. "Is vertical integration anticompetitive?: Definitely maybe (but that's not final)," Journal of Health Economics, Elsevier, vol. 25(1), pages 175-180, January.
    3. Grossman, Sanford J & Hart, Oliver D, 1986. "The Costs and Benefits of Ownership: A Theory of Vertical and Lateral Integration," Journal of Political Economy, University of Chicago Press, vol. 94(4), pages 691-719, August.
    4. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643 Elsevier.
    5. Lynk, William J & Morrisey, Michael A, 1987. "The Economic Basis of Hyde: Are Market Power and Hospital Exclusive Contracts Related?," Journal of Law and Economics, University of Chicago Press, vol. 30(2), pages 399-421, October.
    6. Juan Luis Londoño & Julio Frenk, 1997. "Pluralismo estructurado: Hacia un modelo innovador para la reforma de los sistemas de salud en América Latina," IDB Publications (Working Papers) 7627, Inter-American Development Bank.
    7. Ciliberto, Federico & Dranove, David, 2006. "The effect of physician-hospital affiliations on hospital prices in California," Journal of Health Economics, Elsevier, vol. 25(1), pages 29-38, January.
    8. Pauly, Mark V., 1987. "Monopsony power in health insurance: thinking straight while standing on your head," Journal of Health Economics, Elsevier, vol. 6(1), pages 73-81, March.
    9. George J. Stigler, 1951. "The Division of Labor is Limited by the Extent of the Market," Journal of Political Economy, University of Chicago Press, vol. 59, pages 185-185.
    10. Blois, K J, 1972. "Vertical Quasi-Integration," Journal of Industrial Economics, Wiley Blackwell, vol. 20(3), pages 253-272, July.
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    Citations

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    Cited by:

    1. Grupo de Economía de la Salud & Jairo Humberto Restrepo, 2011. "Evolución de la Seguridad Social en Salud en Colombia: avances, limitaciones y retos," OBSERVATORIO SEGURIDAD SOCIAL 015580, GRUPO DE ECONOMÍA DE LA SALUD.
    2. Sandra Rodriguez A., 2015. "Poder de monopsonio en el mercado de aseguramiento en salud en Colombia," REVISTA DE ECONOMÍA DEL CARIBE 014779, UNIVERSIDAD DEL NORTE.

    More about this item

    Keywords

    health economics; industrial organization; vertical integration; health care insurance; profits; prices;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L22 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Organization and Market Structure

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