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Welfare Analysis Incorporating a Structural Entry-Exit Model:
A Case Study of Medicare HMOs



Shiko Maruyama


June, 2006


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Abstract
Should the government subsidize entry to promote competition? In theory, free entry does not guarantee the socially optimum number of entrants. In differentiated product markets, free entry can result either in excessive or insufficient entry. In this paper I propose an empirical framework to address this issue with a case study of the Medicare HMO market for 2003 and 2004. I perform counterfactual welfare simulations with different entry conditions and with different government payment rates to HMOs. The results indicate that uniformly raising the payment rate lowers national welfare, which supports the government's efforts to contain the payment rate in my sample years. A comparison of the cases with and without entry and/or market power indicates that this welfare loss does not come from additional entry, but instead the oligopolistic market structure and market distortion from the payment rate subsidy. The number of entrants is likely to be insufficient.
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