Health Care Unit
The health care industry consists of many different providers, including subsidized health care providers, hospitals, rehabilitation centers, general practitioners, physiotherapists, medical specialists, pharmacies, and medical-equipment manufacturers. In addition, health insurers play a critical role in the industry. They are given the director’s chair to achieve health care that is affordable and of high quality.
Education
Working closely together with the Dutch Healthcare Authority (NZa), the NMa has put much effort in educating the industry in recent years. Examples of this joint approach include the Guidelines for the Health Care Industry, a vision document on buying power, the Guidelines on Health Care Groups, and the conference on specialization for the hospital industry. The purpose of education is to offer health care providers who want to cooperate a framework, explaining what is and what is not allowed under the Dutch Competition Act.
Enforcement
Since several years now, the NMa has increasingly attached education to regulatory enforcement. For example, the NMa has dealt with market-sharing agreements made by home care providers, it looked into the so-called ‘location policy’ of general practitioners, and it is investigating a possible abuse of dominance by producers of brand-name drugs. In addition, several Amsterdam-based hospitals have adjusted their information-exchange processes.
Mergers and acquisitions
Furthermore, with its merger control activities, the NMa prevents competition on several health care markets from becoming impeded as a result of a merger, for example, because of the possibility of harmful dominant positions being created.
The NMa carried out investigations into the possible effects of certain mergers in home care, mental health care, nursing home care, and hospital care. Such investigations have resulted in parties either cancelling or adjusting their merger plans.
Cooperation with the Dutch Healthcare Authority (NZa)
The NMa and the NZa work closely together. The NMa reviews health care concentrations, and it enforces the prohibition of cartels. In addition, the NMa comes into action in cases of abuse of dominance. The NZa also plays a role here: it can impose obligations on health care providers or health insurers, if they enjoy dominant positions, in order to prevent abuse thereof.
So the NMa enforces the rules when abuse has been established, whereas the NZa is able to prevent abuse from occurring in the first place. In addition, the NZa sets rules, budgets and tariffs for the regulated segments of the health care market, and it sets conditions for those segments of the market that are fully or partially being liberalized.
