Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro

Detalhes bibliográficos
Autor(a) principal: Almeida, Sílvia Fagá de
Data de Publicação: 2009
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional do FGV (FGV Repositório Digital)
Texto Completo: http://hdl.handle.net/10438/4259
Resumo: The countervailing power created by those damaged in an asymmetrical power relationship may be beneficial in terms of welfare. The analysis based on the framework proposed by Dobson et al. (1998) drove to the conclusion that such conditions are restrictive and are directly related to the interdependence recognition and cooperation among stakeholders. It was also observed that, differently from the outcomes of Dobson et al. (1998) analysis, the creation of countervailing power may have a positive welfare effect even though parties do not recognize their interdependency and do not cooperate with each other – what depends on the relationship of price-elasticity of demand and supply. Despite the possibility of positive effects, the antitrust doctrine in Brazil and in other jurisdictions such as USA and European Community apply the countervailing power concept mistakenly or completely ignore its existence. However, the goal of antitrust policy and the creation of compensatory power are aligned: the balance of power asymmetries in relations between agents, preventing the abuse of power in the transaction. Thus, there is an incongruity between court decisions and economic theory. The conflict in applying the countervailing power concept by antitrust doctrine can be clearly observed in the Brazilian health care sector. Physicians often coordinate themselves into cooperatives in order to counteract the exercise of buying power by health insurance firms. However, this agreement among physicians, presumably competitors, has been condemned by antitrust authorities based on the interpretation that such collective bargain is a cartel – an antitrust offence. This study investigates – using panel data econometric method – if collective bargain enables physicians to exercise countervailing power and increases social welfare. The empiric analysis corroborates theoretical propositions: in the healthcare sector, at least in the price dimension, there is a possibility of positive effects related to countervailing power. However, it must be noted that such a result would be related to cooperatives condemned by CADE, which should represent the group of associations that would effectively deter economic power to counterbalance the power asymmetry in negotiations with healthcare service providers. Given that fact, it is important to reassess CADE’s decisions regarding physicians’ cooperatives as a public policy aiming to increase social welfare.
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spelling Almeida, Sílvia Fagá deEscolas::EESPSouza, Sérgio Aquino deBarrionuevo Filho, ArthurLucinda, Cláudio Ribeiro deFarina, Elizabeth Maria Mercier QueridoAzevedo, Paulo Furquim de2010-04-20T21:40:53Z2010-04-20T20:56:56Z2009-05-19ALMEIDA, Sílvia Fagá de. Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro. Tese (Doutorado em Economia de Empresas) - FGV - Fundação Getúlio Vargas, São Paulo, 2009.http://hdl.handle.net/10438/4259The countervailing power created by those damaged in an asymmetrical power relationship may be beneficial in terms of welfare. The analysis based on the framework proposed by Dobson et al. (1998) drove to the conclusion that such conditions are restrictive and are directly related to the interdependence recognition and cooperation among stakeholders. It was also observed that, differently from the outcomes of Dobson et al. (1998) analysis, the creation of countervailing power may have a positive welfare effect even though parties do not recognize their interdependency and do not cooperate with each other – what depends on the relationship of price-elasticity of demand and supply. Despite the possibility of positive effects, the antitrust doctrine in Brazil and in other jurisdictions such as USA and European Community apply the countervailing power concept mistakenly or completely ignore its existence. However, the goal of antitrust policy and the creation of compensatory power are aligned: the balance of power asymmetries in relations between agents, preventing the abuse of power in the transaction. Thus, there is an incongruity between court decisions and economic theory. The conflict in applying the countervailing power concept by antitrust doctrine can be clearly observed in the Brazilian health care sector. Physicians often coordinate themselves into cooperatives in order to counteract the exercise of buying power by health insurance firms. However, this agreement among physicians, presumably competitors, has been condemned by antitrust authorities based on the interpretation that such collective bargain is a cartel – an antitrust offence. This study investigates – using panel data econometric method – if collective bargain enables physicians to exercise countervailing power and increases social welfare. The empiric analysis corroborates theoretical propositions: in the healthcare sector, at least in the price dimension, there is a possibility of positive effects related to countervailing power. However, it must be noted that such a result would be related to cooperatives condemned by CADE, which should represent the group of associations that would effectively deter economic power to counterbalance the power asymmetry in negotiations with healthcare service providers. Given that fact, it is important to reassess CADE’s decisions regarding physicians’ cooperatives as a public policy aiming to increase social welfare.A criação de poder compensatório decorrente da ação concertada daqueles prejudicados em uma relação de poder assimétrica pode gerar aumento de bem-estar social. O desenvolvimento analítico a partir da estrutura proposta por Dobson et al. (1998) permite constatar que as condições para que sejam verificados os efeitos positivos são restritivas e estão diretamente relacionadas ao reconhecimento da interdependência e à cooperação entre os agentes envolvidos. Foi possível observar também que, diferentemente do que previu a análise de Dobson et al. (1998), a criação de poder compensatório pode ter efeitos positivos em termos de bem-estar, ainda que as partes não reconheçam sua interdependência e não cooperem entre si – o que depende da relação das elasticidades-preço da demanda e da oferta. A despeito da possibilidade de efeitos benéficos, as doutrinas de defesa da concorrência brasileira e nas demais jurisdições, como EUA e Comunidade Européia, aplicam de maneira equivocada o conceito de poder compensatório ou ignoram por completo sua existência. Há que se considerar, contudo, que o objetivo da política antitruste e o da criação de poder compensatório estão alinhados: equilíbrio de assimetrias de poder nas relações entre os agentes, coibindo o exercício abusivo do poder de uma das partes na transação. Verifica-se, portanto, uma incongruência entre a jurisprudência e a teoria econômica. O conflito na aplicação do conceito de poder compensatório pela doutrina antitruste pode ser nitidamente observado no mercado de saúde suplementar brasileiro. Um fenômeno verificado nesse setor é a coordenação de médicos em cooperativas para fazer frente ao exercício de poder de compra por parte das operadoras de planos de saúde. Essa ação concertada tem sido condenada pelas autoridades de defesa da concorrência com base na interpretação de que a coordenação entre médicos constitui formação de cartel, passível de condenação pelas autoridades antitruste. A análise empírica corrobora as proposições teóricas: no setor de saúde suplementar, pelo menos na dimensão preço, existe a possibilidade de efeitos positivos associados ao poder compensatório. Destaca-se, contudo, que esse resultado estaria associado às cooperativas condenadas pelo CADE, que devem representar o grupo de associações que efetivamente deteriam poder econômico para equilibrar a assimetria de poder na negociação com as operadoras de planos de saúde. Diante dessa constatação, é importante reavaliar as decisões do CADE acerca das cooperativas médicas enquanto política pública que visa aumentar o bem-estar social.porCountervailing powerCompetition policyHealth insuranceSaúde suplementarDefesa da concorrênciaEconomiaConcorrência - BrasilDireito antitruste - Aspectos econômicosAssistência médica - Custos - BrasilAssociações médicas - BrasilPoder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiroinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisreponame:Repositório Institucional do FGV (FGV Repositório Digital)instname:Fundação Getulio Vargas (FGV)instacron:FGVinfo:eu-repo/semantics/openAccessTHUMBNAILSilvia_Faga_Almeida_2009.pdf.jpgSilvia_Faga_Almeida_2009.pdf.jpgGenerated 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dc.title.por.fl_str_mv Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
title Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
spellingShingle Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
Almeida, Sílvia Fagá de
Countervailing power
Competition policy
Health insurance
Saúde suplementar
Defesa da concorrência
Economia
Concorrência - Brasil
Direito antitruste - Aspectos econômicos
Assistência médica - Custos - Brasil
Associações médicas - Brasil
title_short Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
title_full Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
title_fullStr Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
title_full_unstemmed Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
title_sort Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
author Almeida, Sílvia Fagá de
author_facet Almeida, Sílvia Fagá de
author_role author
dc.contributor.unidadefgv.por.fl_str_mv Escolas::EESP
dc.contributor.member.none.fl_str_mv Souza, Sérgio Aquino de
Barrionuevo Filho, Arthur
Lucinda, Cláudio Ribeiro de
Farina, Elizabeth Maria Mercier Querido
dc.contributor.author.fl_str_mv Almeida, Sílvia Fagá de
dc.contributor.advisor1.fl_str_mv Azevedo, Paulo Furquim de
contributor_str_mv Azevedo, Paulo Furquim de
dc.subject.eng.fl_str_mv Countervailing power
Competition policy
Health insurance
topic Countervailing power
Competition policy
Health insurance
Saúde suplementar
Defesa da concorrência
Economia
Concorrência - Brasil
Direito antitruste - Aspectos econômicos
Assistência médica - Custos - Brasil
Associações médicas - Brasil
dc.subject.por.fl_str_mv Saúde suplementar
Defesa da concorrência
dc.subject.area.por.fl_str_mv Economia
dc.subject.bibliodata.por.fl_str_mv Concorrência - Brasil
Direito antitruste - Aspectos econômicos
Assistência médica - Custos - Brasil
Associações médicas - Brasil
description The countervailing power created by those damaged in an asymmetrical power relationship may be beneficial in terms of welfare. The analysis based on the framework proposed by Dobson et al. (1998) drove to the conclusion that such conditions are restrictive and are directly related to the interdependence recognition and cooperation among stakeholders. It was also observed that, differently from the outcomes of Dobson et al. (1998) analysis, the creation of countervailing power may have a positive welfare effect even though parties do not recognize their interdependency and do not cooperate with each other – what depends on the relationship of price-elasticity of demand and supply. Despite the possibility of positive effects, the antitrust doctrine in Brazil and in other jurisdictions such as USA and European Community apply the countervailing power concept mistakenly or completely ignore its existence. However, the goal of antitrust policy and the creation of compensatory power are aligned: the balance of power asymmetries in relations between agents, preventing the abuse of power in the transaction. Thus, there is an incongruity between court decisions and economic theory. The conflict in applying the countervailing power concept by antitrust doctrine can be clearly observed in the Brazilian health care sector. Physicians often coordinate themselves into cooperatives in order to counteract the exercise of buying power by health insurance firms. However, this agreement among physicians, presumably competitors, has been condemned by antitrust authorities based on the interpretation that such collective bargain is a cartel – an antitrust offence. This study investigates – using panel data econometric method – if collective bargain enables physicians to exercise countervailing power and increases social welfare. The empiric analysis corroborates theoretical propositions: in the healthcare sector, at least in the price dimension, there is a possibility of positive effects related to countervailing power. However, it must be noted that such a result would be related to cooperatives condemned by CADE, which should represent the group of associations that would effectively deter economic power to counterbalance the power asymmetry in negotiations with healthcare service providers. Given that fact, it is important to reassess CADE’s decisions regarding physicians’ cooperatives as a public policy aiming to increase social welfare.
publishDate 2009
dc.date.issued.fl_str_mv 2009-05-19
dc.date.accessioned.fl_str_mv 2010-04-20T21:40:53Z
dc.date.available.fl_str_mv 2010-04-20T20:56:56Z
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dc.identifier.citation.fl_str_mv ALMEIDA, Sílvia Fagá de. Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro. Tese (Doutorado em Economia de Empresas) - FGV - Fundação Getúlio Vargas, São Paulo, 2009.
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10438/4259
identifier_str_mv ALMEIDA, Sílvia Fagá de. Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro. Tese (Doutorado em Economia de Empresas) - FGV - Fundação Getúlio Vargas, São Paulo, 2009.
url http://hdl.handle.net/10438/4259
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