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Competition in Health Insurance Markets

[Symposium: Competition in Health Care]

By Martin Gaynor and Amanda Starc

Journal of Economic Perspectives, Spring 2026

The United States relies primarily on private health insurance markets, yet these markets are highly concentrated and becoming more so over time. We document concentration across commercial, Medicare Advantage, and Medicaid markets. We then examine how as...

Substitutes for Success? Public versus Private Competition in Medicare Advantage

[Symposium: Competition in Health Care]

By Tim Layton, Luca Maini, and J. Michael McWilliams

Journal of Economic Perspectives, Spring 2026

We assess the evolving role of competition in Medicare Advantage and its implications for beneficiary welfare. We describe how competition from the public option, traditional Medicare, and other private insurers within Medicare Advantage act as substitute...

The Current Era of Health Care Consolidation

[Symposium: Competition in Health Care]

By Michael R. Richards and Christopher M. Whaley

Journal of Economic Perspectives, Spring 2026

Consolidation in the last few decades has reshaped the organization and structure of US health care markets, among both providers and insurers. Nearly all US hospital and insurer markets exceed established regulatory thresholds for competitive markets, an...

Physician Competition: Entry and Substitution

[Symposium: Competition in Health Care]

By Joshua D. Gottlieb and Sean Nicholson

Journal of Economic Perspectives, Spring 2026

We describe competition in the physician market, focusing on how entry barriers and substitution possibilities have changed in recent decades. Regulatory caps on medical school seats and residency slots—especially for high-paying specialties—continue ...

Regulated Competition in Health Insurance Markets on Two Sides of the Atlantic

[Symposium: Competition in Health Care]

By Lukas Kauer, Thomas G. McGuire, Sonja Schillo, and Richard C. van Kleef

Journal of Economic Perspectives, Spring 2026

Many high-income countries implement their policy of universal health insurance by individual health insurance in combination with regulated competition among insurers. Supported by public intervention, regulated competition can, in principle, address mar...

The Economics of Paid Sick Leave

By Stefan Pichler, Christopher Prinz, Stefan Thewissen, and Nicolas R. Ziebarth

Journal of Economic Perspectives, Spring 2026

This article examines the economics of paid sick leave from both theoretical and empirical perspectives. Research on paid sick leave has evolved dynamically over the last decade, primarily driven by the spread of US sick pay mandates, which have increased...