Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-22T15:47:17.808Z Has data issue: false hasContentIssue false
  • English
  • Français

The role of EU competition law in health care and the ‘undertaking’ concept

Published online by Cambridge University Press:  30 April 2020

Johan W. van de Gronden  and
Mary Guy Open the ORCID record for Mary Guy [Opens in a new window]
Johan W. van de Gronden
Affiliation:
Professor of European Law, Radboud University Nijmegen, Nijmegen, The Netherlands
Mary Guy*
Affiliation:
Lecturer in Law, Lancaster Law School, Lancaster University, Lancaster, UK
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Part of the controversy surrounding competition and health care stems from the complexity connected with delineating the applicability of competition law – encompassing both the provisions governing anticompetitive agreements and abuse of dominance and the state-aid rules. Cases determined at the European Union (EU) level within the past 30 years have developed a broad framework, and notable trends have emerged – for example, a distinction between health care providers and managing bodies (purchasers). The former have been subject to an ‘abstract’ test and the latter to a more sophisticated ‘concrete’ test. In this paper, we chart the development of the EU courts’ approach to developing the ‘undertaking’ concept in health care and examine the current EU competition law framework with a view to identifying future directions. van de Gronden has recently identified a ‘three-prong’ test of exemption from competition law in connection with the recent CEPPB case: firstly, where the supply of services is predominantly dependent upon public financing; secondly, the public funding aims to achieve a public interest goal and thirdly, the activities concerned are closely related to this public interest goal. We examine this test in a health care context, drawing on our findings regarding Dutch competition reforms.

Keywords

EU health lawEU health policyhealthstate aid
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Special Issue 1: SPECIAL ISSUE: The future of EU health law and policy , January 2021 , pp. 76 - 89
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

ACM (2010) Richtsnoeren voor de zorgsector (Guidelines for the Healthcare Sector), March 2010.Google Scholar
Andreangeli, A (2016) Healthcare services, the EU single market and beyond: meeting local needs in an open economy – how much market or how little market? Legal Issues of Economic Integration 43, 145.Google Scholar
Baquero Cruz, J (2005) Beyond competition: Services of general interest and European Community Law. In de Búrca, G (ed.), EU Law and the Welfare State: In Search of Solidarity. Oxford: Oxford University Press, pp. 169–212.CrossRefGoogle Scholar
Davies, G (2010) The price of letting courts value solidarity: the judicial role in liberalizing welfare. In Ross, M and Borgmann-Prebil, Y (eds), Promoting Solidarity in the European Union, Oxford: Oxford University Press, pp. 106–121.Google Scholar
Dunne, N (2010) Knowing when to see it: state activities, economic activities and the concept of undertaking. Columbia Journal of European Law 16, 427.Google Scholar
Guy, M (2019) Competition Policy in Healthcare: Frontiers in Insurance-Based and Taxation-Funded Systems. Intersentia: Cambridge.CrossRefGoogle Scholar
Hancher, L and Sauter, W (2012) EU Competition and Internal Market Law in the Health Care Sector. Oxford: Oxford University Press.Google Scholar
Krajewski, M and Farley, M (2007) Non-economic activities in upstream and downstream markets and the scope of competition law after FENIN. European Law Review 32, 111–124.Google Scholar
Prosser, T (2010) EU Competition law and public services. In Mossialos, E, Permanand, G, Baeten, R and Hervey, TK (eds), Health Systems Governance in Europe: The Role of European Union Law and Policy. Cambridge: Cambridge University Press, pp. 315–336.CrossRefGoogle Scholar
Ross, M (2010) Solidarity – a new constitutional paradigm for the EU. In Ross, M and Borgmann-Prebil, Y (eds), Promoting Solidarity in the European Union. Oxford: Oxford University Press, pp. 23–45.CrossRefGoogle Scholar
Sánchez Graells, A (2015) Public Procurement and the EU Competition Rules, 2nd Edn., Oxford: Hart Publishing.Google Scholar
Sauter, W (2013) The impact of EU competition law on national healthcare systems. European Law Review 38, 457.Google Scholar
Sinclair, D (2014) ‘Undertakings’ in competition law at the public–private interface – an unhealthy situation. European Competition Law Review 35, 167.Google Scholar
Szyszczak, E (2009) Modernising healthcare: Pilgrimage for the holy grail?. In Krajewski, M, Neergaard, U and van de Gronden, JW (eds), The Changing Legal Framework for Services of General Interest in Europe – Between Competition and Solidarity. The Hague: TMC Asser Press.Google Scholar
van de Gronden, JW (2004) Purchasing care: economic activity or service of general (economic) interest? European Competition Law Review 25, 87.Google Scholar
van de Gronden, JW (2009) Financing health care in EU law: do the European State aid rules write out an effective prescription for integrating competition law with health care? Competition Law Review 6, 5–29.Google Scholar
van de Gronden, JW (2011) The treaty provisions on competition and health care. In Van de Gronden, JW, Szyszczak, E, Neergaard, U and Krajewski, M (eds), Health Care and EU Law. The Hague: TMC Asser Press, pp. 265–290.Google Scholar
van de Gronden, JW (2018) Services of general interest and the concept of undertaking: does EU competition law apply? World Competition 41, 197–224.Google Scholar
van de Gronden, JW and Rusu, CS (2017) EU Competition law and policy and health systems. Chapter 11. In Hervey, TK, Young, CA and Bishop, LE (eds), Research Handbook on EU Health Law and Policy. Cheltenham: Edward Elgar, pp. 267–290.Google Scholar
van de Gronden, JW and Szyszczak, E (2014) Introducing competition principles into health care through EU law and policy: a case study of the Netherlands. Medical Law Review 22, 238.Google ScholarPubMed
Winterstein, A (1999) Nailing the Jellyfish: social security and competition law. European Competition Law Review 6, 324.Google Scholar

EU cases

Case T-216/15 Dôvera zdrvotná poist'ová and Union zdrvotná poist'ová, 5 February 2018, ECLI:EU:T:2018:64.Google Scholar
Case C-74/16 Congregación de Escuelas Pías Provincia Betania, 27 June 2017, ECLI:EU:C:2017:496.Google Scholar
Case C-67/13 Cartes Bancaires, 11 September 2014, ECLI:EU:C:2014:2204.Google Scholar
Case T-90/11 ONP, 10 December 2014, ECLI:EU:T:2014:1049.Google Scholar
Case 437/09 AG2R Prévoyance v Beaudout Père et Fils SARL, 3 March 2011, ECLI:EU:C:2011:112.Google Scholar
Case C-56/09 Zanotti, 20 May 2010, ECLI:EU:C:2010:288.Google Scholar
Case C-8/08 T-Mobile, 4 June 2009, ECLI:EU:C:2009:343.Google Scholar
Case T-289/03 British United Provident Association Ltd (BUPA) et al v Commission, 12 February 2008, ECLI:EU:T:2008:29.Google Scholar
Case C-49/07 MOTOE, 1 July 2008, ECLI:EU:C:2008:376.Google Scholar
Case C-76/05 Schwarz and Gootjes-Schwarz, 11 September 2007, ECLI:EU:C:2007:492.Google Scholar
Case C-318/05 Commission vs Germany, 11 September 2007, ECLI:EU:C:2007:495.Google Scholar
Case C-205/03 P FENIN vs Commission, 11 July 2006, ECLI:EU:C: 2006:e453.Google Scholar
Commission of 22 December 2005 on the introduction of a risk equalisation system in the Dutch Health Insurance Act N541/2004 and N542/2004 – C (2005) 1329 fin.Google Scholar
Case C-205/03 P Federación Española de Empresas de Tecnología Sanitaria (FENIN) vs Commission of the European Communities, Opinion of Mr Advocate General Poiares Maduro delivered on 10.11.2015, ECLI:EU: C:2005:666.Google Scholar
Joined cases C-264/01, C-306/01, C-354/01, and C-355/01 AOK Bundesverband and Others, 16 March 2004, ECLI:EU:C:2004:150.Google Scholar
C-218/00 Cisal ECLI:EU:C:2002:36.Google Scholar
Case C-475-99 Ambulanz Glöckner, 25 October 2001, ECLI:EU:C:2001:577.Google Scholar
Joined Cases C-180/98 to C-184/98 Pavlov [2000] ECR I-6451; [2001] 4 CMLR 1.Google Scholar
Joined cases C-159/91 and C-160/91 Poucet, 17 February 1993, ECLI:EU:C:1993:63.Google Scholar
Case C-109/92 Wirth, 7 December 1993, ECLI:EU:C:1993:916.Google Scholar
Case C-41/90 Höfner, 23 April 1991, ECLI:EU:C:1991:161.Google Scholar
Case 263/86 Humbel, 27 September 1998, ECLI:EU:C:1988:451.Google Scholar
Case 118/85 Commission vs Italy, 16 June 1987, ECLI:EU:C:1987:283.Google Scholar
Joined cases 96-102, 104, 105, 108 and 110/82 IAZ, 8 November 1983, ECLI:EU:C:1983:310.Google Scholar

National cases

Gendia v Dutch Ministry of Health, Wellbeing and Sport, Case No. 200.225.476/01, Gerechtshof Den Haag, 11 December 2018, ECLI:NL:GHDHA:2018:3331.Google Scholar