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An increasing number of markets, particularly health insurance, are characterized by option demand. In option demand markets, intermediaries sell networks of upstream suppliers to downstream consumers; in many cases, consumers must attach a value to the network of suppliers before their needs are realized. Building upon a Logit model of demand, we introduce a method for modeling such markets. Ideally, the intermediaries use their expertise and bargaining power to negotiate better terms than could consumers acting on their own. However, the realization of these savings could be thwarted if the upstream suppliers have significant market power, or are allowed to merge and thereby attain market power. We estimate the model using data on inpatient hospital services in San Diego, California and use our results to simulate the effects of hospital mergers. We find that hospital markets are localized in the sense that mergers among suburban hospitals, or mergers among urban hospitals with considerable service overlap, would lead to significant price increases. This is an important finding. The 1990s witnessed a wave of hospital mergers, relatively few of which were challenged by the Federal Trade Commission or the Department of Justice. At trial after trial, the defendant hospitals prevailed; in most of these cases the judge(s) relied upon patient flow data to conclude that the relevant market is large, and therefore the merger would not be anticompetitive. Our results cast serious doubt upon this conclusion.
We call markets in which intermediaries sell networks of suppliers to consumers who are uncertain about their needs "option demand markets." In these markets, suppliers may grant the intermediaries discounts in order to be admitted to their networks. We derive a measure of each supplier's market power within the network; the measure is based on the additional ex ante expected utility consumers obtain from the supplier's inclusion. We empirically validate the WTP measure by considering managed care purchases of hospital services in the San Diego market. Finally, we present three applications, including an analysis of hospital mergers in San Diego.
Stucke and Ezrachi’s analysis of the nature of competition is refreshingly non-ideological and counterintuitive. Their idea that competition can be either toxic or noble—all depending on how governments structure markets—is something so clear that it’s remarkable it’s taken us decades to recognize the wisdom of it. This is a must-read for anyone interested in how to use public policy to harness the competitive drive for the public good. — Chris Hughes, cofounder of Facebook Stucke and Ezrachi show us the important differences between destructive and noble competition and what we can do to pursue a more just and prosperous world. This book changes how you will view the role of the market in our economy and society at large. — Spencer Weber Waller, director of the Institute for Consumer Antitrust Studies and law professor at Loyola University Chicago Entertaining and thought-provoking, Competition Overdose fiercely articulates the raw, hard truth behind the toxic aspects of competition. — Tommaso Valletti, professor of economics at Imperial College London and Chief Competition Economist (2016–2019), European Commission Competition Overdose is probably the most important book to be published on the subject since The Antitrust Paradox hit the bookshelves in 1978. It is destined to transform how governments across the world think about the role competition in domestic and international policy for decades to come. Stucke and Ezrachi are the new rock stars of competition policy. — Ali Nikpay, partner at Gibson Dunn & Crutcher Anything, in the wrong dosage, can be poisonous. Competition Overdose takes a sacred cow of contemporary western thought—that ‘more competition is always good’—and reveals that while competition can be noble, it can also be toxic. An engaging and compelling read that will make you think differently about situations we all deal with every day. — Tim Wu, professor at Columbia Law School, contributing opinion writer for the New York Times, and author of The Master Switch and The Attention Merchants A must-read for anyone concerned about the future of our economy and society, Competition Overdose provides a no-nonsense analysis of how toxic competition can be bad for competitors, consumers, workers, and society overall. The authors highlight the abuses of this ideology and remind us that we, as citizens and consumers, can exercise our power by choosing products, based on our values. — Monique Goyens, director general of BEUC, The European Consumer Organisation This beautifully written book helps us rethink economic principles from the ground up. As any good chemist knows, what can be helpful or harmless in small doses is deadly in excess. While technocrats push competition as a cure to all economic ailments, Stucke and Ezrachi deliver a dose of reality: cutthroat schemes to kneecap rivals, manipulate customers, and exploit workers harm far more than they help. Read this book for a brilliant account of the proper place of competition (and ethics) in society. — Frank Pasquale, law professor at University of Maryland and author of The Black Box Society Stucke and Ezrachi examine a multitude of perversities in today’s society—colleges striving to recruit applicants they likely will reject, supermarkets stocking hundreds of varieties of jam, travel deals stuffed with hidden fees—and provide a unifying explanation: a misalignment of competition. Their book illuminates how competition can go wrong, and how individuals, businesses, and the government can set it right. — Jonathan Levin, dean of Stanford Graduate School of Business Is more competition the solution to all our societal problems? Stucke and Ezrachi persuasively say: No, it depends; sometimes we need to rein in markets because they produce socially inferior outcomes. This book shows that the promotion of competition cannot be an end in of itself, but rather it should be used as a tool to improve overall welfare. Between too much and too little competition, the safest option is, as always, the ‘aurea mediocritas’” — Jorge Padilla, senior managing director and head of Compass Lexecon, Europe Stucke and Ezrachi ask critical questions about what types of rivalry are desirable and who benefits when all domains of society are governed by principles of unfettered competition. Countering simplistic prescriptions, Competition Overdose is a perceptive and timely read. — Lina Khan, author of Amazon’s Antitrust Paradox Competition Overdose is a courageous, timely attempt by two formidable legal scholars to unpack—and in some cases demolish—the dominant shibboleth of our age: the delusion that ‘more competition’ is the remedy for many social or economic ills. Should be required reading for every course in public policy. — John Naughton, professor at University of Cambridge and technology columnist for the London Observer The authors draw skillfully on a wide range of disciplines, from economics to psychology, to help us understand why more competition is not always all that it’s cracked up to be. They provide support for a more humane, nobler form of competition and wider corporate purpose, debunking the myths of shareholder value and blind faith in markets. This is a must-read. — Simon Holmes, UK Competition Appeal Tribunal Because competition has been sold for centuries as an unbridled positive, reading this book requires counterintuitive thinking and an open mind. Using a lucid, conversational style, the authors thoroughly explain each case study and anecdote. Does competition regularly result in a race to the bottom? Yes, the authors maintain, and they present ideas about how to achieve what they term ‘noble competition,’ in which sellers, buyers, and society at large all benefit. — Kirkus Reviews
The most important book on antitrust ever written. It shows how antitrust suits adversely affect the consumer by encouraging a costly form of protection for inefficient and uncompetitive small businesses.
With the rise of digital platforms and the natural tendency of markets involving platforms to become concentrated, competition authorities and courts are more frequently in a position to investigate and decide merger and abuse cases that involve platforms. This report provides guidance on how to define markets and on how to assess market power when dealing with two-sided platforms. DEFINITION Competition authorities and courts are well advised to uniformly use a multi-markets approach when defining markets in the context of two-sided platforms. The multi-markets approach is the more flexible instrument compared to the competing single-market approach that defines a single market for both sides of a platform, as the former naturally accounts for different substitution possibilities by the user groups on the two sides of the platform. While one might think of conditions under which a single-market approach could be feasible, the necessary conditions are so severe that it would only be applicable under rare circumstances. To fully appreciate business activities in platform markets from a competition law point of view, and to do justice to competition law’s purpose, which is to protect consumer welfare, the legal concept of a “market” should not be interpreted as requiring a price to be paid by one party to the other. It is not sufficient to consider the activities on the “unpaid side” of the platform only indirectly by way of including them in the competition law analysis of the “paid side” of the platform. Such an approach would exclude certain activities and ensuing positive or negative effects on consumer welfare altogether from the radar of competition law. Instead, competition practice should recognize straightforwardly that there can be “markets” for products offered free of charge, i.e. without monetary consideration by those who receive the product. ASSESSMENT The application of competition law often requires an assessment of market power. Using market shares as indicators of market power, in addition to all the difficulties in standard markets, raises further issues for two-sided platforms. When calculating revenue shares, the only reasonable option is to use the sum of revenues on all sides of the platform. Then, such shares should not be interpreted as market shares as they are aggregated over two interdependent markets. Large revenue shares appear to be a meaningful indicator of market power if all undertakings under consideration serve the same sides. However, they are often not meaningful if undertakings active in the relevant markets follow different business models. Given potentially strong cross-group external effects, market shares are less apt in the context of two-sided platforms to indicate market power (or the lack of it). Barriers to entry are at the core of persistent market power and, thus, the entrenchment of incumbent platforms. They deserve careful examination by competition authorities. Barriers to entry may arise due to users’ coordination failure in the presence of network effect. On two-sided platforms, users on both sides of the market have to coordinate their expectations. Barriers to entry are more likely to be present if an industry does not attract new users and if it does not undergo major technological change. Switching costs and network effects may go hand in hand: consumer switching costs sometimes depend on the number of platform users and, in this case, barriers to entry from consumer switching costs increase with platform size. Since market power is related to barriers to entry, the absence of entry attempts may be seen as an indication of market power. However, entry threats may arise from firms offering quite different services, as long as they provide a new home for users’ attention and needs.