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Insurance access and demand response: Pricing and welfare implications.

David Besanko1, David Dranove1, Craig Garthwaite2

  • 1Kellogg School of Management, Northwestern University, United States.

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Summary
This summary is machine-generated.

Health insurance can increase treatment costs by enabling higher prices for liquidity-constrained patients. This economic model explains why pharmaceutical prices may exceed treatment value, especially with expanded insurance coverage.

Keywords:
Complementary monopolyHealth insurance accessLiquidity constraintsPharmaceutical prices

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Area of Science:

  • Health economics
  • Pharmaceutical pricing
  • Insurance market dynamics

Background:

  • Liquidity-constrained patients face barriers to accessing unaffordable medical treatments.
  • Monopolistic pricing strategies in the healthcare sector are a significant concern.
  • The relationship between health insurance coverage and pharmaceutical pricing requires further economic modeling.

Purpose of the Study:

  • To develop an economic model analyzing the impact of health insurance on treatment accessibility and pricing.
  • To investigate how health insurance influences a monopolist's pricing decisions for medical treatments.
  • To provide an economic rationale for observed pharmaceutical pricing strategies.

Main Methods:

  • A theoretical economic model was developed to simulate patient access to treatments under different insurance scenarios.
  • The model analyzed profit-maximizing pricing strategies of a monopolist provider.
  • The study examined the effects of cost-sharing mechanisms and expanded insurance coverage on prices and consumer surplus.

Main Results:

  • Health insurance enables liquidity-constrained patients to access otherwise unaffordable treatments.
  • A monopolist sets higher prices for insured treatments compared to non-insured ones, even with cost-sharing.
  • Consumer surplus may decrease under such insurance and pricing structures.
  • The model offers an economic explanation for pharmaceutical prices exceeding product-derived value.
  • Increased insurance coverage for monopoly-provided services exacerbates pricing issues.

Conclusions:

  • Health insurance, while improving access, can inadvertently lead to higher treatment costs due to monopolistic pricing.
  • The findings challenge standard moral hazard models, highlighting a distinct mechanism driving prices.
  • The study provides a theoretical basis for concerns about pharmaceutical firms setting prices above treatment value.
  • Policy implications suggest careful consideration of insurance design and market structures for monopoly-provided services.