Pauly Mark V, Burns Lawton R
Wharton School, University of Pennsylvania, in Philadelphia, USA.
Health Aff (Millwood). 2008 Nov-Dec;27(6):1544-53. doi: 10.1377/hlthaff.27.6.1544.
Hospital buyers of medical devices contract with manufacturers with market power that sell differentiated products. The medical staff strongly influences hospitals' choice of devices. Sellers have sought to limit disclosure of transaction prices. Policy-makers have proposed legislation mandating disclosure, in the interest of greater transparency. We discuss why a manufacturer might charge different prices to different hospitals, the role that secrecy plays, and the consequences of secrecy versus disclosure. We argue that hospital-physician relationships are key to understanding what manufacturers gain from price discrimination. Price disclosure can catalyze a restructuring of those relationships, which, in turn, can improve hospital bargaining.
医疗设备的医院采购方与具有市场支配力且销售差异化产品的制造商签订合同。医务人员对医院的设备选择有很大影响。销售方一直试图限制交易价格的披露。政策制定者已提议立法强制披露价格,以提高透明度。我们讨论了制造商可能向不同医院收取不同价格的原因、保密所起的作用以及保密与披露的后果。我们认为,医院与医生的关系是理解制造商从价格歧视中获利的关键。价格披露可能促使这些关系进行重组,进而改善医院的议价能力。