1. COMPETITION POLICY IN BISMARCK AND BEVERIDGE HEALTHCARE SYSTEMS: HOW DO COMPETITION LAW, ECONOMIC REGULATION AND MERGER CONTROL OPERATE IN DUTCH AND ENGLISH HEALTHCARE? Mary Guy UEA Law School / Centre for Competition Policy (CCP), University of East Anglia (UEA), Norwich. UK. AHRC Medicine Markets Morals Network Meeting Three University of Liverpool in London, 27 May 2016 1/6

2. Overview… 1. Introduction… 2. Context… 3. Competition law and healthcare provision in England (s.72 HSCA 2012) and the Netherlands – substantive focus. 4. Monitor/NHS Improvement and the CMA’s concurrent powers (s.72 HSCA 2012) and the Dutch healthcare regulator’s and ACM’s “separate powers” – institutional focus – competition and regulatory powers. 5. Amendments to merger control as applied in Dutch and English healthcare (s.79 HSCA 2012). 6. Conclusions… 2/6

3. How does EU competition law apply to healthcare systems? Service of General Interest (SGI) No Yes Purchasers? -FENIN; - AOK Bundesverband. Providers:. -Pavlov. Service of General Economic Interest (SGEI) Ambulanz Glöckner Risk Equalisation Schemes “Undertaking”? “Economic activity” (Höfner) Offering goods or services on a market (Commission v Italy) 3/6

4. The Dutch “healthcare triangle” Patients Health Insurers Providers 4/6 Art. 122 Health Insurance Act 2006 AOK Bundesverband

5. The 4 categories of English healthcare… 5/6 1 Public Purchaser + Public Provider 2 Public Purchaser + Private Provider 3 Private Purchaser + Public Provider 4 Private Purchaser + Private Provider FENIN

6. Any Questions? Thank you! 6/6