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Health Aff (Millwood). 2014 Jun;33(6):1076-82. doi: 10.1377/hlthaff.2013.1183. Epub 2014 May 19.

Getting the product right: how competition policy can improve health care markets.

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William M. Sage ( is the James R. Dougherty Chair for Faculty Excellence, School of Law, University of Texas at Austin.


As hospital, physician, and health insurance markets consolidate and change in response to health care reform, some commentators have called for vigorous enforcement of the federal antitrust laws to prevent the acquisition and exercise of market power. In health care, however, stricter antitrust enforcement will benefit consumers only if it accounts for the competitive distortions caused by the sector's long history of government regulation. This article directs policy makers to a neglected dimension of health care competition that has been altered by regulation: the product. Competition may have failed to significantly lower costs, increase access, or improve quality in health care because we have been buying and selling the wrong things. Competition policy makers-meaning both antitrust enforcers and regulators-should force the health care industry to define and market products that can be assembled and warranted to consumers while keeping emerging sectors such as mHealth free from overregulation, wasteful subsidy, and appropriation by established insurer and provider interests.


Health Reform; Legal/Regulatory Issues; Organization and Delivery of Care

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