一叶知秋——《经济学人》文章欣赏阅读VI

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　　美国著名药品零售商要收稿安泰健康保险，这在媒体上引起轩然大波。国内的医疗健康同样也是我们所关注的话题，就以这篇文章来看一看我们考研英语的词汇。
　　American health care
　　Prescription debate
　　美国医疗
　　处方药之争
　　Should regulators block CVS Health from buying Aetna?
　　监管机构是否应阻止CVS Health(美国最 大药品零售商)收购安泰(美国安泰健康保险公司)?
　　AMERICA has a competition problem. Market concentration has risen in more than three-quarters of industries since the late 1990s. Concentration has led to higher profits and higher returns for shareholders at the expense of consumers.
　　美国的竞争出问题了。上世纪90年代末以来，七成以上行业市场集中度上升。集中投资牺牲消费者利益，带来更高的利润和股民收益。
　　Antitrust authorities have become more supine: between 1970 and 1999, regulators brought an average of 16 cases a year in order to prevent big firms from becoming even bigger; between 2000 and 2014, that number fell below three.
　　反托拉斯机构管理松懈：1970-1999年间，监管机构为防止大公司继续扩张，每年平均处理16起案件，而2000-2014年间，只有不到3起。
　　Health care is one of the industries that has been marked by bouts of consolidation. The annual number of hospital mergers in America doubled between 2005 and 2015; the national market share of the four largest insurers went from 74% in 2006 to 83% in 2014. Trustbusters have recently showed more teeth. In February a federal judge blocked a proposed tie-up between Aetna and Humana, two health insurers. Antitrust authorities pruned an acquisition by Walgreens of Rite Aid, America’s second- and fifth-largest pharmacies respectively.
　　医疗行业是集中明显的行业之一，2005-2015年，美国医院年度合并数量翻了一番;四大保险公司所占全国市场份额从2006年的74%上升到2014年的83%。反托拉斯机构最近频频出招，今年2月，一名联邦法官否决了Aetna和两家医疗保险公司之间的合并计划。反垄断机构阻止了沃尔格林的收购，双方分别是美国第二大及第五大药房。
　　They may soon face another big test. CVS Health, the largest pharmacy, is reportedly in talks to buy Aetna for $66bn (see page 63), in what would be the country’s biggest-ever health-insurance deal. At first glance, it is hard to see why trustbusters would wave through this deal if they have balked at others. But look closer and the picture becomes more complex.
　　他们可能很快就会面临又一个重大考验。据报道，最 大药品零售商CVS Health正在洽谈以660亿美元收购Aetna，这会成为国内有史以来最 大的医疗保险交易。乍一看，很难理解反托拉斯机构为何阻止其他收购，却在这一事件上犹豫不决。仔细想想，事情并不是那么简单。
　　Trustbusters have been clamping down on “horizontal” mergers between direct rivals, such as Aetna and Humana. The CVS-Aetna deal would be a different animal. It is an example of “vertical integration”, in which separate bits of a supply chain are brought together under one roof. This tie-up would reach across three distinct layers of the health-care industry: the retail pharmacies for which CVS is famous; the pharmacy-benefit managers (PBM), intermediaries which negotiate drug prices on behalf of medical plans and whose number again includes CVS; and the insurers, like Aetna. Supporters of the deal argue that aligning the interests of insurers and pharmacies would reduce costs and improve life for consumers. An insurer that could send patients to walk-in clinics of the sort CVS owns would be better placed to monitor and improve results.
　　反托拉斯机构历来打击直接竞争对手的“横向”合并，如Aetna和Humana(美国哈门那医药公司)，CVS-Aetna收购案却不同，这是“纵向合并”的案件。这个案件中，同一供应链的各部分整合在一起，这一联盟覆盖医疗行业的三个不同层次：药品零售商(也是CSV的主营业务)、医疗福利管理机构(PBM)、代表医疗计划进行药价谈判的中间商，其中又包括CVS以及像Aetna一样的保险企业。收购案的支持者认为，调整保险公司和医药零售商的利益可以降低成本，改善消费者的生活。如果保险公司能够把病人送往CSV旗下的诊所，就能更好地监控和改善效果。

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　　Antitrust types are usually less worried by the vertical integration of powerful firms than they are by horizontal mergers between them. The more market power a firm has, the greater its ability to set prices above the level that would prevail in a competitive market. If two such firms exist along a supply chain, prices are inflated at each stage. A tie-up between supplier and customer can solve this problem of “double marginalisation”. As a result, vertical integration can achieve lower prices for consumers.
　　比起横向兼并，反托拉斯的人通常不太担心大公司纵向合并。公司的市场影响力越大，它就越有能力在竞争中让价格高于普遍水平。如果有两家这样的公司存在于供应链中，那么每个阶段的价格都会抬高。供应商和消费者联合可以解决“双重边缘化”的问题。因此，纵向整合可以为消费者带来更低的价格。
　　In the case of CVS-Aetna, the incentive for the pharmacy-benefit manager to fatten its profits would disappear. The question then is would that benefit accrue to the consumer? That depends on whether firms are dominant in their respective markets. The benefits to consumers of a vertical merger disappear if one of the parties has a monopoly. The proposed deal between AT&T and Time Warner, for instance, fails this test. The monopoly that AT&T wields as a broadband provider in many parts of America means that rivals to Time Warner have no simple options for getting their content distributed there. Uncontested markets would have a similar impact on the CVS-Aetna deal: a combined entity would be free to restrict insured customers to CVS medications and clinics, for example, if it had no rivals to fear.
　　在CVS-Aetna案例中，医疗福利管理机构(PBM)增加利润的动机会消失，问题在于消费者是否会从中受益，这取决于公司是否在各自的市场中占主导地位。如果一方产生垄断，纵向整合的好处就会消失。例如，AT&T(美国电话电报公司)与时代华纳的拟议交易，就未能通过这项测试。AT&T作为宽带供应商在美国很多地方占垄断地位，意味着时代华纳的竞争对手要想让内容分发到那里的话，别无选择。没有竞争的市场将会对CVS-Aetna的交易产生类似影响，比如，没有竞争对手的话，合并后的实体可以随意把投保人限制在CVS的药物和诊所中。
　　Bitter pill or better pill?
　　苦果还是甘露?
　　That seems unlikely. CVS has about 23% of the pharmacy market, and 24% of the PBM market; Aetna has about 6% of the insurance market. And more competition may be on the way in the pharmacy business: the prospective entry of Amazon lies behind CVS’s hunt for Aetna. But the deal would require close scrutiny and may need conditions attached. A proposed agreement with Anthem, another insurer, which would give CVS an even bigger slice of the PBM pie would need to be ditched. And the local picture matters. In the median American state, for example, the two largest health insurers have 66% of the market. Trustbusters might need to insist on the sale of some local assets to smaller rivals before approving a tie-up.
　　这似乎不太可能。CVS约占药品市场23%，占PBM市场24%，Aetna占保险市场6%左右。医药行业会出现更多竞争， CVS收购Aetna之后，谋划对亚马逊出手。但该交易需要仔细审查，也可能需要附加条件，即抛弃与另一家保险公司Anthem达成的协议，那会让CVS在PBM中份额更重。当地情况很重要，这两个最 大的医疗保险公司在美国中部州拥有66%的市场份额。反托拉斯机构可能需要在批准合并前，坚持要求把当地小公司卖给较小的竞争对手。
　　Make no mistake, America’s competition problem is real, and its messed-up health-care system would not be fixed by any single deal. But the bar to blocking a vertical tie-up like CVS-Aetna is high. It is not obvious that this bar is met.
　　没毛病，美国的竞争问题真实存在，其混乱的医疗系统不会被任何单一的交易固定，但阻止像CSV-Aetna这样的纵向整合阻力巨大。此案能否成功尚不明朗。
　　同学们，文章的大概意思了解了，单词记住的同时，你们支持合并吗?
　　以上是中公考研为大家准备整理的“一叶知秋——《经济学人》文章欣赏阅读VI”的相关内容。更多参考书、成功经验的信息请点击这里哦。另外，为了帮助考生更好地复习考研，中公考研为广大学子推出 2018考研冲刺集训、一对一协议班、名校保研精品班系列备考专题，中公经济学教研室针对每一个科目要点与每年的大纲进行深入并具有针对性的指导分析，欢迎各位考生了解咨询。同时，中公考研一直为大家推出考研直播课堂，足不出户就可以边听课边学习，为大家的考研梦想助力!