How to Get Away with Merger: Stealth Consolidation and its Effects on Us Healthcare

Abstract

Only large mergers must be reported to the US government, so many anticompetitive deals may effectively avoid antitrust scrutiny. This paper uses data from the dialysis industry to show that premerger notifications are essential to antitrust enforcement and that ensuing enforcement actions preserve competition and protect consumers, evidenced by lower hospitalization and mortality rates. It then studies the effect of eliminating premerger notification exemptions. To do so, I estimate a structural model of quality competition. I find the counterfactual policy saves thousands of lives, yielding benefits that far exceed reasonable estimates of the additional costs of enforcement.