The Role of Competition Rules in the Context of Healthcare Reform in the Netherlands

The Netherlands is an early mover in healthcare liberalisation. It has a dual policy towards competition enforcement in the sector: not only the general competition rules (the prohibitions on cartels and the abuse of dominance, and merger control) but also rules of sector specific competition policy apply. Consequently the general Competition Authority and the Healthcare Authority have concurrent powers in this field. This paper examines both the basis for intervention (generally related to market failure and market power), the balance between general rules and specific cases, some of the technical problems involved (such as geographic market definition), and the institutional setting. In this context the new competition powers of the Healthcare Authority based on findings of significant market power by individual undertakings, respectively of structural problems involving entire categories of providers, are also reviewed. A number of case summaries are presented by way of example