Competition Policy in Healthcare

A health insurance system or a taxation-funded National Health Service (NHS)? Universal healthcare provision or marketization and competition? This book explores the development of competition policy in Dutch and English healthcare in light of tensions arising from these seemingly opposed ideas.

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This book examines competition policy (competition law, merger control and sectoral regulation) in English and Dutch healthcare. In contrast to the United States, competition in English and Dutch healthcare develops from the principle of universal access to healthcare, which appears antithetical to competition. Unsurprisingly, competition reforms in both a health insurance system (the Netherlands) and a taxation-funded National Health Service (NHS) (England) have proved controversial. Such reforms are also proving difficult to implement, with both countries developing “healthcare-specific” modifications of general competition rules and differing relationships between the competition authorities and healthcare regulators in applying these.

This book challenges both existing literature and the policy underpinning the reforms by adopting the position that healthcare is fundamentally different to other liberalized sectors and thus requires special treatment. Furthermore, it argues that different approaches are needed to accommodate the specific characteristics of national healthcare systems (such as the tension between the NHS and private healthcare in the UK) within the wider typology of insurance-based and taxation-funded systems across Europe. It also provides a first context-based comparative law study in this area.

This analysis is timely in light of ongoing criticism of the reforms and current refocusing of competition within healthcare in both countries.