Poder compensatório e política de defesa da concorrência: referencial geral e aplicação ao mercado de saúde suplementar brasileiro
Autor(a) principal: | |
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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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
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 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional do FGV (FGV Repositório Digital) instname:Fundação Getulio Vargas (FGV) instacron:FGV |
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Fundação Getulio Vargas (FGV) |
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FGV |
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FGV |
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Repositório Institucional do FGV (FGV Repositório Digital) |
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Repositório Institucional do FGV (FGV Repositório Digital) |
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