title: Competition rules and health care players: principles and consequences.
abstract: OBJECTIVE
  Competition rules maximise consumer welfare by promoting efficient use of scarce resource and thus high output, low prices, high quality, varied services, innovation, production and distribution. European courts consider doctors and hospital staff as undertakings (any entity that performs economic activities), so that if they enter into agreements then they have to comply with competition rules. This paper's objective is to determine whether competition law, which applies to undertakings, can in fact be applied to different healthcare-sector players and whether specific rules are needed regarding competition between healthcare undertakings.
  
  
  METHODS
  Data were selected from relevant European and national case law, European institution legal documents (such as regulations, guidelines and communications) and healthcare competition law literature, and then examined.
  
  
  RESULTS
  The paper finds that competition rules are applicable to healthcare players considering the consequences if competition rules are applied to the healthcare market. For market processes to result in the appropriate cost, quality and output, competition law must be proactive. In other words, quality must be fully factored into the competitive mix, allowing consumers to weigh healthcare price and non-price characteristics.
  
  
  CONCLUSIONS
  Countries have different healthcare system and competition rules (although similar), competition rule impact is different for each country. Some healthcare systems are more regulated and there will be less opportunity for healthcare players to compete.
  
  
  CONCLUSIONS
  Efficiently applying competition law to healthcare players means that several challenges need facing, such as healthcare quality complexity and court scepticism.
  
  
  CONCLUSIONS
  This article points out the challenges when competition law is applied to the healthcare sector and how these challenges are faced in certain countries such as The Netherlands.
authors.affiliation: Centre for Biomedical Ethics and Law, Catholic University Leuven, Leuven, The Netherlands. Diego.Fornaciari@med.kuleuven.be
authors.forename: Diego
authors.initials: D
authors.lastname: Fornaciari
authors.forename: Stefaan
authors.initials: S
authors.lastname: Callens
mesh_terms: D016363:Antitrust Laws / Q000458:organization & administration; D004345:Drug Industry / Q000458:organization & administration; D004465:Economic Competition / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D005062:European Union; D019981:Health Care Sector / Q000191:economics / Q000458:organization & administration*; D006282:Health Personnel / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006739:Hospital Administration; D006801:Humans; D011787:Quality of Health Care / Q000458:organization & administration