ABSTRACT

As a country, the United States spends significantly more on healthcare than other advanced industrialized countries, and Americans have comparably worse health outcomes. Both are developments of the last four decades. In this paper, we look at how change in antitrust and patent law and thus change in market power in the largest four subsectors of healthcare, hospitals, physician groups, prescription drugs, and net medical insurance, have contributed to the increasing cost of medical care in the United States. We show that the annual rent – the degree to which health care is overpriced as a result of market power – was between 2.47 and 4.30 percent of GDP in 2016 – truly a big cost for big medicine.

摘要

作为一个国家，美国在医疗保健方面的支出明显高于其他发达工业化国家，而美国人的健康状况相对较差。两者都是过去四个十年的发展。在本文中，我们研究了反垄断法和专利法的变化，以及医疗保健、医院、医师团体、处方药和网络医疗保险这四个最大的子行业市场力量的变化如何导致医疗保健成本增加在美国。我们表明，2016 年的年租金——医疗保健因市场力量而被高估的程度——占 GDP 的 2.47% 至 4.30% 之间——对于大型医药公司来说确实是一笔巨大的成本。