Member of the board Henk Don's response to Frieslab study into bottlenecks in the health care industry
'Try to come up with new organizations forms that are even better for patients'Last week, Frieslab, a research group that was created by the Dutch Ministry of Health, the northern Dutch province of Friesland and two other parties, presented a study into bottlenecks in the health care industry. Henk Don, member of the board of the Netherlands Competition Authority (NMa), reacts to their findings: 'In their study, they argue that the Dutch Competition Act in its current form would be too complicated for health care providers, and not be clear enough. For example, they claim that it slows down cooperation between health care providers. Findings like there may inadvertently help create an incorrect idea of what the Competition Act really is all about.
The NMa is actually in favor of cooperation between health care providers. The Dutch Competition Act even offers room for providers to cooperate, only up until the point when customers become harmed or may become harmed. This includes situations such as higher prices for health care, or worse quality.
Health care providers from different fields that cooperate have to nothing to fear from the NMa. By harmonizing their health care products and services, they are able to improve health care quality and efficiency – strictly speaking, they would then be offering integrated care. We will be keeping a close watch when health care providers within the same field cooperate. This may restrict the patient's freedom of choice, which in turn may result in health care providers not doing their best to be, for example, customer-friendly and service-oriented. A restriction of freedom of choice could be justified if it was sufficiently offset by gains such as higher quality or lower prices of health care.
We believe that there are risks if cooperations within the same field go beyond what is strictly necessary for price or quality improvement, or if, on balance, they actually hurt customers rather than help them. In that case, health care providers can ask themselves two questions. First, are all of the elements of the collaboration really necessary? Discussing prices and sharing markets are clearly not. The second question is whether the collaboration actually needs that many health care providers from the same field. Would it not work with less health care providers from the same field?
The NMa is unable and unwilling to give its approval to any form of organization in advance. This is because the Dutch Competition Act is not so much looking into organization forms as into what their direct effects on patients and insured are. These effects may evolve and change over time. Furthermore, we want to give room to and stimulate entrepreneurship and the development of new organization forms. I am a staunch proponent of innovation. So my advice to health care providers would be to just do your best and try to come up with new organization forms that are even better for patients.
What the NMa can do, is informing everyone what is and is not risky behavior, which is something we already do a lot. For example, we spend much time and effort in educating the health care industry about what options the Dutch Competition Act has to offer to the industry. We recently published two brochures on Guidelines for the health care industry and on Guidelines for Integrated Care Providers. In addition, we give numerous presentations throughout the Netherlands.'