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Public health insurance in the future will be subject to competition law. The Bundestag approved this on Thursday by vote  of a coalition presented by the federal government, making an amendment to the Act against Restraints of Competition (GWB).

The federal government wants to ensure that mergers of funds or collaborations are not too powerful. With their placement under the antitrust laws, it should also ensure more choice for members, as the amendment has been made ahead of the vote on optional plans and the levy of additional contributions. The reform is to apply from 1 January 2013.

In the Committee on Economics and Technology, the coalition had changed the draft on Wednesday. After that the competition authorities will be in charge of applying the laws to the GWB-supply contract of insurance. In the amendment it is now clear that voluntary cooperation is still possible. These include the cooperative association for mammography screening or the common missions of substitute funds at country level.

Commentary: The application of competition law brings new market elements into the market of health insurance. On the contract market there are now back issues such as price fixing and aggregation of large funds that will come into the focus of the Bundeskartellamt. Antitrust law sees the funds as „buyers“ of services. When companies join together in purchasing, they limit competition that exists between them. The amendment to the law here is to ensure that health insurers get no dominant positions through mergers.

In the contract market, the providers are exposed by the ongoing consolidation among the insurers, giving thema growing bargaining power. It remains to be seen whether the new law helps stabilise the negotiating balance between public health insurers and providers.

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