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

18 Pages Posted: 2 Feb 2010 Last revised: 6 Feb 2010

Wolf Sauter

Tilburg Law and Economics Center (TILEC); Dutch Healthcare Authority; Tilburg Law School

Date Written: January 1, 2010


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.

Keywords: healthcare, liberalisation, merger control, significant market power, state aid, market failure, regulation, competition policy and healthcare, sectoral competition policy

JEL Classification: I, I18, K, K21, K23, K32

Suggested Citation

Sauter, Wolf, The Role of Competition Rules in the Context of Healthcare Reform in the Netherlands (January 1, 2010). TILEC Discussion Paper No. 2010-004. Available at SSRN: or

Wolf Sauter (Contact Author)

Tilburg Law and Economics Center (TILEC) ( email )

Warandelaan 2
Tilburg, 5000 LE

Dutch Healthcare Authority ( email )

Postbus 3017
Utrecht, 3502 GA

Tilburg Law School

Tilburg, 5000 LE

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