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合谋的人力代价:墨西哥胰岛素卡特尔的健康影响

The Human Cost of Collusion: Health Effects of a Mexican Insulin Cartel
Journal of the European Economic Association · 2023 · Aaron Barkley

中文摘要

尽管近来人们对竞争在决定发达国家健康结果中的作用给予关注,但对于市场势力如何阻碍低收入国家获得优质医疗服务,人们知之甚少。本文研究政策变化的影响,这些政策变化终止了向墨西哥最大医疗服务提供者之一供应胰岛素的厂商之间的合谋。我记录了在卡特尔瓦解导致胰岛素价格骤降之后,胰岛素使用量增加,糖尿病并发症和死亡率下降。这些不利健康结果扩大了卡特尔所造成损害的评估范围。这些发现凸显了医疗市场中市场设计政策的重要性,尤其是对低收入和中等收入国家而言。

Abstract

Abstract Despite recent attention to the role of competition in determining health outcomes in developed nations, little is known about how market power impedes access to quality care in lower-income countries. This paper studies the effects of policy changes that stopped collusion among firms supplying insulin to one of Mexico’s largest health care providers. I document increased insulin utilization and decreased diabetes complications and mortality following the sudden drop in insulin prices caused by the cartel’s collapse. These adverse health outcomes expand the assessment of damages caused by the cartel. The findings highlight the importance of market design policies in health markets, particularly for low- and middle-income countries.
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