I have been the Managing Editor of the Journal of Economic Perspectives since the first issue in Summer 1987. The JEP is published by the American Economic Association, which decided back in 2011–to my delight–that the journal would be freely available online, from the current issue all the way back to the first issue. You can download individual articles or entire issues, and it is available in various e-reader formats, too. Here, I’ll start with the Table of Contents for the just-released Spring 2026 issue, which in the Taylor household is known as issue #156. Below that are abstracts and direct links for each of the papers. I plan to blog more specifically about some of the papers in the few weeks, as well.
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Symposium on Competition in Health Care
“The Emerging Role of Competition in Health Care,” by Paul B. Ginsburg
This essay, commissioned to serve as an introduction to the JEP symposium on current competition in health care, provides a historical perspective on the role of both competition and regulation in the financing and delivery of health services since the implementation of Medicare and Medicaid in the mid-1960s. At the beginning of this period, few could perceive a role for competition in healthcare given the key role played by physicians in providing and ordering care and concerns that lower prices might signal lower quality. Initial attempts to slow rapidly rising costs involved various regulatory tools, but over time, regulation increasingly incorporated incentives for providers, to control costs. Competitive approaches began to develop in the late 1970s, in part reflecting broad changes in the nation’s political culture. Competitive approaches are now quite widespread, but regulation plays an important role in the structuring of competition and in addressing areas where competition is seen as having less potential.
“Competition in Health Insurance Markets,” by Martin Gaynor and Amanda Starc
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 asymmetric information—particularly adverse selection—interacts with market power to shape premiums, plan design, and consumer welfare. Empirical evidence confirms that insurer consolidation raises premiums. We discuss how antitrust enforcement, risk adjustment, regulation, and informational interventions shape competition and consumer welfare in these markets.
“Regulated Competition in Health Insurance Markets on Two Sides of the Atlantic,” by Lukas Kauer, Thomas G. McGuire, Sonja Schillo, and Richard C. van Kleef
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 market failures in health insurance and smooth out some inequities in the financial consequences of ill health and in the ability to pay for health insurance. We compare the national systems in Germany, the Netherlands, and Switzerland to the US Marketplaces, all of which use versions of regulated competition. While they show many similarities (for example, open enrollment, community-rated premiums with subsidies, comprehensive benefit package, risk adjustment), we focus on three major differences and their implications for market functioning: (1) mandatory and universal versus voluntary and partial (applying to only one sector of health insurance); (2) greater or lesser profit orientation of insurers; and (3) reliance on markets or regulation to contain costs.
“Anticompetitive Contracts between Insurers and Providers in Health Care,” by Anna D. Sinaiko
For people with private health insurance in the United States, contracts between insurers and providers are important to fostering health care competition and improving efficiency. However, insurer-provider contract provisions do not always advance competition and consumer welfare. This essay discusses the contracting strategies used by insurers to increase competition, and four anticompetitive contract terms: anti-tiering or anti-steering, all-or-nothing, most favored nation, and gag clauses, that may be used by dominant health systems to protect themselves from competition. I conclude with a discussion of policy responses that can be used to address provider use of anticompetitive clauses and that can reduce the negative impacts of provider market power. Understanding anticompetitive contract provisions and the potential policy responses to limit their impact is critical to health care competition.
“The Current Era of Health Care Consolidation,” by Michael R. Richards and Christopher M. Whaley
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, and over half of physicians are now employed by a hospital or health system, which can increase spending for patients, payers, and taxpayers. Increased supply-side concentration can alter the balance of negotiations between providers and insurers. Prices for patients with commercial insurance are approximately 2.5 times the prices paid by those with public insurance. High and variable prices have minimal link with higher quality, and the United States leads peer nations in health care spending. These dynamics have created ongoing national debates over an “affordability crisis” and generates frustrations with the US health care system. This article discusses sources of rising health care spending and potential policy solutions.
“Physician Competition: Entry and Substitution,” by Joshua D. Gottlieb and Sean Nicholson
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 to ration entry, generate high returns for those who gain these slots, and direct the most academically accomplished trainees toward lucrative fields. But trained physicians increasingly compete with nurse practitioners, physician assistants, and other mid-level practitioners in the market for patients. Training of these substitutes has expanded far more rapidly than physician supply. We present key facts about the physician pipeline, a conceptual framework linking specialty earnings to entry barriers, and describe the rise of mid-level providers. These facts mean that effective competition policy in physician markets must look beyond conventional concentration measures and focus on the institutions and laws that govern who can provide medical care.
“Substitutes for Success? Public versus Private Competition in Medicare Advantage,” by Tim Layton, Luca Maini, and J. Michael McWilliams
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 substitutes in incentivizing plans to deliver value. We show that while historically the choice between traditional Medicare and Medicare Advantage provided a vital competitive dynamic, traditional Medicare’s strength as a competitor has declined significantly, driven by generous payments favoring private plans. Consequently, the burden of ensuring value for enrollees has shifted to competition within the Medicare Advantage market. While county-level competition among private insurers has increased, this growth is primarily driven by the expansion of large national carriers rather than new entrants. Insurers still wield substantial market power due to significant barriers to entry, raising concerns about the ability of the program to incentivize private insurers to use public dollars to maximize value for beneficiaries.
“Understanding Medicaid Managed Care: The Procured Competition Model,” by Mark Shepard and Jacob Wallace
Medicaid is one of the largest public programs in the United States—providing health insurance to over 75 million low-income Americans—and over three quarters of its enrollees receive care via private “managed care” insurers. In this article, we make three central points about the economics of contracting out Medicaid to private insurers. First, the empirical evidence on Medicaid privatization is mixed: contracting out has not meaningfully reduced public costs or improved quality of care. Second, we propose a framework, which we call “procured competition,” to describe the unique structure of Medicaid managed care as a hybrid of public procurement and regulated competition. Third, we discuss the key policy levers across procurement, competition, and consumer choice in this model. Throughout, we highlight open research questions, arguing that the enormous variation in how states design these programs—combined with limited evidence on what works—represents a promising area for high-impact scholarship.
Articles
“A Users’ Guide to Uncovering Worker and Firm Effects: The ABC of AKM,” by Stéphane Bonhomme, Thibaut Lamadon, and Elena Manresa
The AKM model introduced by Abowd, Kramarz, and Margolis (1999) has become a workhorse to study worker and firm heterogeneity, and to understand the sources of wage dispersion in the labor market using linked employer-employee data. In this article, we introduce the model and estimator, discuss some best practices for estimation, and review some empirical findings on the role of worker and firm heterogeneity in wage dispersion. While the AKM methodology has proven useful to analyze a host of questions in a variety of settings within labor economics and beyond, we also point to the need for methodological developments.
“The Economics of Paid Sick Leave,” by Stefan Pichler, Christopher Prinz, Stefan Thewissen, and Nicolas R. Ziebarth
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 paid sick leave access from 63 percent to 77 percent in all US jobs. We begin by discussing the economic rationales for government regulation of paid sick leave, particularly the negative externalities associated with contagious diseases when individuals work while sick. After that, we discuss the key trade-offs in the general design of paid sick leave schemes, along with the trade-offs when setting specific policy parameters. Finally, we review economic modeling approaches to study optimal paid sick leave policies.
Features
“Retrospectives: The Great Dollar-Shortage Debate,” by Harris Dellas and George S. Tavlas
The dollar shortage debate—Paul Samuelson called it “the big open question of our time”—dominated international macroeconomics in the 15 years following the end of World War II. There were two main views regarding its cause: financial frictions that limited capital flows to Western Europe (Kindleberger); and overvalued fixed exchange rates versus the US dollar (Friedman). According to Kindleberger the dollar shortage was attenuated by two real factors that contributed to current account deficits: a large technological gap between the United States and Europe; and European impatience to improve living standards. Kindleberger believed that the current account deficit would prove chronic because of the persistence of the productivity gap, a view that was challenged by Bloomfield who argued that it would dissipate through income growth in Europe. We argue that Kindelberger’s analytical framework is closely connected to the modern intertemporal approach to current account determination; and, also, that the international reserve function of the US dollar—the Triffin dilemma—did not play a role in the dollar shortage.
“Recommendations for Further Reading,” by Timothy Taylor