BACKGROUND The health sector reform in Colombia, initiated by Law 100 (1993) that introduced a managed competition model, is generally presented as a successful experience of improving access to care through a health insurance regulated market. The study's objective is to improve our understanding of the factors influencing access to the continuum of care in the Colombian managed competition mo...

Abstract: We analyze the effect that competition between HMOs has on the cost and quality of medical services. Our key result is that increasing competition enhances consumer utility while also moderating the impact of managed care on quality and costs. Indeed, we find that heightened competition between HMOs can cause an overall increase in care quality and costs. This result derives from an i...

Since the early 1990s, policy analysts seeking important opportunities for reform in the Medicare program have looked at the experience of private markets and managed care in the private sector. Managed care organizations (“MCOs”), in general, and health maintenance organizations (“HMOs”), in particular, seem to have hit the wall in recent years in their ability to contain costs. They have expe...

We examine the effect of the evolution of President Clinton’s health care reform proposal over January 1992–October 1993 on pharmaceutical stock prices. We identify a 52.3 percent decline in market-adjusted prices, which we then associate with health care reform. Applying a new technique, isotonic regression, we find most of the decline occurred gradually. Much of the decline occurred as the Cl...

The Federal Trade Commission and Department of Justice 2004 report Improving Health Care: A Dose of Competition expresses a clear allegiance to competition as the organizing principle for health care. In Europe, by contrast, the key organizing principle of health care systems is solidarity. Solidarity means that all have access to health care based on medical needs, regardless of ability to pay...