Healthcare markets are forming in Europe. Some countries, such as the UK, have introduced competitive forces in their health systems as a means to improve their efficiency and quality. The role of competition in healthcare is a hotly debated topic with some considering it “anathema” and others seeing it as “a magic bullet.” Aiming to spark this heated, albeit unsettled, debate, this article raises an additional concern: it contends that when competitive forces are introduced into a health system, the main actors involved in the provision of healthcare, mainly physicians acting either as gatekeepers or purchasers of healthcare services may enter into agreements that restrict competition among healthcare providers with a view to protecting equity and access to care. This article asks the wider question: should competition authorities in Europe consider in their competition analysis the core objectives their health systems strive to attain, such as equity? How and to what extent can antitrust enforcers integrate distributive concerns into their competition assessment on the basis of Article 101 TFEU?


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