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Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs

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  • Shiko Maruyama

Abstract

Should the government subsidize entry to promote competition? In theory, free entry does not guarantee the socially optimum number of entrants. In differentiated product markets, free entry can result either in excessive or insufficient entry. In this paper I propose an empirical framework to address this issue with a case study of the Medicare HMO market for 2003 and 2004. I perform counterfactual welfare simulations with different entry conditions and with different government payment rates to HMOs. The results indicate that uniformly raising the payment rate lowers national welfare, which supports the government's efforts to contain the payment rate in my sample years. A comparison of the cases with and without entry and/or market power indicates that this welfare loss does not come from additional entry, but instead the oligopolistic market structure and market distortion from the payment rate subsidy. The number of entrants is likely to be insufficient.

Suggested Citation

  • Shiko Maruyama, 2006. "Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs," Hi-Stat Discussion Paper Series d06-166, Institute of Economic Research, Hitotsubashi University.
  • Handle: RePEc:hst:hstdps:d06-166
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    References listed on IDEAS

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    1. Federico Ciliberto & Elie Tamer, 2009. "Market Structure and Multiple Equilibria in Airline Markets," Econometrica, Econometric Society, vol. 77(6), pages 1791-1828, November.
    2. David Besanko & David Dranove & Mark Shanley, 2001. "Exploiting a Cost Advantage and Coping with a Cost Disadvantage," Management Science, INFORMS, vol. 47(2), pages 221-235, February.
    3. Steven T. Berry & Joel Waldfogel, 1999. "Free Entry and Social Inefficiency in Radio Broadcasting," RAND Journal of Economics, The RAND Corporation, vol. 30(3), pages 397-420, Autumn.
    4. Paul Contoyannis & Andrew M. Jones & Roberto Leon-Gonzalez, 2004. "Using simulation-based inference with panel data in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 101-122.
    5. repec:cdl:compol:217 is not listed on IDEAS
    6. Shiko Maruyama, 2006. "Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs," Hi-Stat Discussion Paper Series d06-166, Institute of Economic Research, Hitotsubashi University.
    7. Leemore Dafny & David Dranove, 2008. "Do report cards tell consumers anything they don't already know? The case of Medicare HMOs," RAND Journal of Economics, RAND Corporation, vol. 39(3), pages 790-821.
    8. Bresnahan, Timothy F. & Reiss, Peter C., 1991. "Empirical models of discrete games," Journal of Econometrics, Elsevier, vol. 48(1-2), pages 57-81.
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    Cited by:

    1. Shiko Maruyama, 2009. "Estimating Sequential-move Games by a Recursive Conditioning Simulator," Discussion Papers 2009-01, School of Economics, The University of New South Wales.
    2. Shiko Maruyama, 2006. "Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs," Hi-Stat Discussion Paper Series d06-166, Institute of Economic Research, Hitotsubashi University.
    3. Abe Dunn, 2009. "Does Competition Among Medicare Advantage Plans Matter?: An Empirical Analysis of the Effects of Local Competition in a Regulated Environment," EAG Discussions Papers 200905, Department of Justice, Antitrust Division.
    4. Lustig, Joshua, 2008. "The Welfare Effects of Adverse Selection in Privatized Medicare," Department of Economics, Working Paper Series qt7n09099j, Department of Economics, Institute for Business and Economic Research, UC Berkeley.

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