The impact of geographic market definition on the stringency of hospital merger control in Germany and the Netherlands

Health Economics, Policy, and Law
Marco Varkevisser, Frederik T Schut

Abstract

In markets where hospitals are expected to compete, preventive merger control aims to prohibit anticompetitive mergers. In the hospital industry, however, the standard method for defining the relevant market (SSNIP) is difficult to apply and alternative approaches have proven inaccurate. Experiences from the United States show that courts, by identifying overly broad geographic markets, have underestimated the anticompetitive effects of hospital mergers. We examine how geographic hospital markets are defined in Germany and the Netherlands where market-oriented reforms have created room for hospital competition. For each country, we discuss a landmark case where definition of the geographic market played a decisive role. Our findings indicate that defining geographic hospital markets in both countries is less complicated than in the United States, where antitrust analysis must take managed care organisations into account. We also find that different methods result in much more stringent hospital merger control in Germany than in the Netherlands. Given the uncertainties in defining hospital markets, the German competition authority seems to be inclined to avoid the risk of being too permissive; the opposite holds for the Dutch co...Continue Reading

References

Dec 13, 2006·Annual Review of Public Health·Marci Kramish CampbellMonica Baskin
Jul 19, 2008·Health Economics, Policy, and Law·Marco VarkevisserFrederik T Schut
Aug 8, 2009·International Journal of Health Care Finance and Economics·Marco VarkevisserFrederik T Schut
Sep 16, 2009·The Milbank Quarterly·David Dranove, Andrew Sfekas
Jul 28, 2010·Journal of Health Services Research & Policy·Thomas Weil
Jan 29, 2011·Health Economics, Policy, and Law·Frederik T Schut, Wynand P M M van de Ven

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Citations

Dec 9, 2015·Health Policy·Andreas Schmid, Marco Varkevisser
Jul 26, 2015·Health Economics Review·Corinna HentschkerAndreas Schmid
Mar 6, 2015·Health Policy·Edith M H Loozen
Oct 20, 2012·Health Economics, Policy, and Law·Corinna Sorenson
Mar 24, 2018·Evaluation : the International Journal of Theory, Research and Practice·Martijn FelderAntoinette de Bont
May 8, 2020·Journal of Health Organization and Management·David de KamRoland Bal

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