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NMa: New Rules for the AWBZ Sector Make Competition Possible

As a result of amendments to regulations applicable to the AWBZ sector, the healthcare sector governed by the Exceptional Medical Expenses Act [Algemene wet bijzondere ziektekosten, AWBZ], room has been created for suppliers of special healthcare to compete with each other. This means that the Netherlands Competition Authority (NMa) can apply the Competition Act to this sector, according to the regulator in an information and consultation document published today. NMa supervises compliance with the prohibition on cartels and the abuse of dominant positions. In addition, NMa assesses mergers and takeovers.

On the basis of questions and provisional conclusions, NMa has asked providers, recipients of healthcare and other interested parties to give their views on the consequences of amendments to the Exceptional Medical Expenses Act. For instance, NMa asks to what extent suppliers and buyers of special healthcare, who can now develop activities on each other's markets, expect to be able to compete with each other. In addition, questions are asked with regard to the extent to which obstacles to competition still exist, such as concentrations on the demand side (healthcare agencies) and on the supply side (scarcity), and the barriers that exist, for instance with regard to entry into these markets. NMa is also interested in the opinions of healthcare providers with regard to the role of healthcare agencies and alignment of their policies to demand from the insured.

The information and consultation document has been published on NMa's website and has also been sent to the various parties involved. The parties have until 15 August 2003 to respond in writing to NMa's analyses and opinions. NMa will also organise a meeting on 14 August at which the parties may present their opinions verbally. NMa will present its view of the operation of market forces in the special medical care sector (AWBZ sector) in a 'Vision Document on the Special Healthcare Sector (AWBZ)’. Publication of this document is planned for the third quarter of 2003.

By means of amendments to the Exceptional Medical Expenses Act, effective as of 1 April 2003, the government wishes to improve the operation of market forces in the sector. By promoting market forces, the suppliers of special healthcare will be given an incentive to provide a wide range of healthcare products efficiently, which are better matched to the demands of patients. By giving patients more freedom of choice, suppliers will also be given an incentive to provide good-quality care.

This report fits within the framework of its activities within the healthcare sector which NMa announced in NMa Agenda 2003. This sector is undergoing a transition from supply-driven to demand-driven healthcare. The point of departure of government policy is that market forces may assist in bringing about a better match between supply and demand. More market forces in the healthcare sector may also result in efficiency improvements.

If a demand-driven healthcare sector is to be realised, it is crucial that the entry of new competitors onto the market is not impeded and that competition between existing market players is not restricted. NMa takes action against prohibited practices that restrict competition. NMa investigates both the supply and demand sides of the market. The conclusions from the report into the operation of market forces in the special healthcare sector governed by the Exceptional Medical Expenses Act (the ‘ABWZ sector’) are important because NMa will base its enforcement policy on this.

see also Informatie- en consultatiedocument AWBZ