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Erschienen in: Review of Industrial Organization 4/2017

04.11.2017

Economics at the Antitrust Division 2016–2017: Healthcare, Nuclear Waste, and Agriculture

verfasst von: Ari D. Gerstle, Helen C. Knudsen, June K. Lee, W. Robert Majure, Dean V. Williamson

Erschienen in: Review of Industrial Organization | Ausgabe 4/2017

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Abstract

This year the Antitrust Division of the U.S. Department of Justice litigated an unprecedented number of cases. Two mergers, Anthem with Cigna and Aetna with Humana, threatened to dramatically alter the face of commercial health insurance. The Anthem case raised questions of how to evaluate a claim that competition costs billions annually in potential medical cost savings. The Aetna case raised questions of how commercial insurers compete against the public programs—specifically Medicare. The Division also litigated numerous other civil matters including a proposed merger of nuclear waste disposal facilities. In that case, economists had to explore the scope and bounds of competition within a variety of regulatory regimes. And, in a merger of two new technologies that improve the efficiency of planting seeds, the emerging nature of the market led to interesting variations in the analysis. This overview of the economic issues in these particular cases is intended to provide insights into the challenges of enforcing antitrust law and the way in which economic analysis in particular is used to address those challenges.

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Fußnoten
1
See Wall Street Journal July 24, 12015, “Anthem Agrees to Buy Cigna for $48.4 Billion”.
 
2
See pp. 3–9 of the Complaint (available at https://​www.​justice.​gov/​atr/​case/​us-and-plaintiff-states-v-anthem-inc-and-cigna-corp) for a more detailed discussion of the commercial health insurance industry and the roles of Anthem and Cigna within it.
 
3
See U.S. Department of Justice and Federal Trade Commission Horizontal Merger Guidelines (2010), section 10. Hereafter, Horizontal Merger Guidelines.
 
4
For these kinds of contracts, the insurance company is primarily providing access to the insurer’s contractual network of healthcare providers and to its administrative services and expertise.
 
5
See U.S. and Plaintiff States v. Anthem, Inc. and Cigna Corp. Memorandum Opinion (available at https://​www.​justice.​gov/​atr/​case/​us-and-plaintiff-states-v-anthem-inc-and-cigna-corp and hereafter Anthem Opinion) p. 114 for a discussion of this and other evidence on which the court relied in deciding that Anthem had failed to prove that its prediction of efficiencies was credible.
 
6
Anthem Opinion, p. 112.
 
8
See pp. 4–5 of the Complaint in U.S. and Plaintiff States v. Aetna Inc., and Humana Inc. (the Complaint and other materials from the case are available at https://​www.​justice.​gov/​atr/​case/​us-and-plaintiff-states-v-aetna-inc-and-humana-inc) for a more detailed discussion of the two companies and their Medicare Advantage products.
 
9
U.S. and Plaintiff States v. Aetna, Inc. and Humana Inc. Memorandum Opinion (hereafter Aetna Opinion) p. 34.
 
10
Aetna Opinion p. 43.
 
11
Town and Liu (2003), Atherly et al. (2004), Dafny and Dranove (2008), Dunn (2010), Hall (2011) and Curto et al. (2015).
 
13
We should note that LLRW is the waste that is suitable for commercial disposal. It does not include the spent fuel from nuclear reactors or components of the cores of decommissioned nuclear reactors, for example. It does include a great deal of material that gets exposed to radiation—everything from filters that are integral to operating the plant to the soil around a decommissioned facility. As a result, nuclear facilities generate substantial amounts of LLRW and pay significant sums every year to ensure that the LLRW is disposed of safely.
 
14
U.S. v. Energy Solutions, Inc., et al. Memorandum Opinion, pp. 17–18. Available at https://​www.​justice.​gov/​atr/​case-document/​file/​1007831/​download. Hereafter Energy Solutions Opinion.
 
15
Energy Solutions Opinion, pp. 22–23.
 
16
Energy Solutions Opinion, p. 25.
 
17
Energy Solutions Opinion, pp. 35, 38.
 
18
Energy Solutions Opinion, p. 37.
 
19
Specifically, defendants did not show that—but for the sale to their competitor—the assets would exit the industry: that no other potential buyer would continue to operate them. While they had made some efforts to seek such a buyer, the court deemed those insufficient to support the conclusion (Energy Solutions Opinion, pp. 49–51).
 
20
Energy Solutions Opinion, pp. 34–38.
 
21
Energy Solutions Opinion, pp. 41–43.
 
22
See the U.S. v. Deere & Company, et al. materials that are available at https://​www.​justice.​gov/​atr/​case/​us-v-deere-company-et-al.
 
23
Even if the market had somehow achieved equilibrium from its first sales, one might still wonder if the data from only one or two cycles of sales could accurately identify key parameters. The coincidence of depressed agricultural markets in these years would make the limited period of data particularly challenging.
 
Literatur
Zurück zum Zitat Atherly, A., et al. (2004). The effect of benefits, premiums, and health risk on health plan choice in the medicare program. Health Services Research, 39(4), 847–864.CrossRef Atherly, A., et al. (2004). The effect of benefits, premiums, and health risk on health plan choice in the medicare program. Health Services Research, 39(4), 847–864.CrossRef
Zurück zum Zitat Curto, V. et al. (2015). Can health insurance competition work? Evidence from medicare advantage. Working paper, pp. 1–48. Curto, V. et al. (2015). Can health insurance competition work? Evidence from medicare advantage. Working paper, pp. 1–48.
Zurück zum Zitat Dafny, L., & Dranove, D. (2008). Do report cards tell consumers anything they don’t already know? The case of Medicare HMOs. RAND Journal of Economics, 39(3), 790–821.CrossRef Dafny, L., & Dranove, D. (2008). Do report cards tell consumers anything they don’t already know? The case of Medicare HMOs. RAND Journal of Economics, 39(3), 790–821.CrossRef
Zurück zum Zitat Dunn, A. (2010). The value of coverage in the medicare advantage insurance market. Journal of Health Economics, 29(6), 839–855.CrossRef Dunn, A. (2010). The value of coverage in the medicare advantage insurance market. Journal of Health Economics, 29(6), 839–855.CrossRef
Zurück zum Zitat Hall, A. E. (2011). Measuring the return on government spending on the medicare managed care program. B.E. Journal of Economic Analysis and Policy, 11(2), 1–41.CrossRef Hall, A. E. (2011). Measuring the return on government spending on the medicare managed care program. B.E. Journal of Economic Analysis and Policy, 11(2), 1–41.CrossRef
Zurück zum Zitat Shapiro, C. (1996). Mergers with differentiated products. Antitrust, 10, 23–30. Shapiro, C. (1996). Mergers with differentiated products. Antitrust, 10, 23–30.
Zurück zum Zitat Town, R., & Liu, S. (2003). The welfare impact of Medicare HMOs. RAND Journal of Economics, 34(4), 719–736.CrossRef Town, R., & Liu, S. (2003). The welfare impact of Medicare HMOs. RAND Journal of Economics, 34(4), 719–736.CrossRef
Metadaten
Titel
Economics at the Antitrust Division 2016–2017: Healthcare, Nuclear Waste, and Agriculture
verfasst von
Ari D. Gerstle
Helen C. Knudsen
June K. Lee
W. Robert Majure
Dean V. Williamson
Publikationsdatum
04.11.2017
Verlag
Springer US
Erschienen in
Review of Industrial Organization / Ausgabe 4/2017
Print ISSN: 0889-938X
Elektronische ISSN: 1573-7160
DOI
https://doi.org/10.1007/s11151-017-9599-3

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