In both the United Kingdom and the Netherlands, competition plays an important role in healthcare. Governments have made the provision of healthcare services subject to market forces. This policy has met with fierce opposition from some, while others consider it to be the Holy Grail for solving major problems, such as the increasing rise of healthcare costs. People tend to either oppose introducing competition in healthcare or to embrace this development. But what does introducing competition in healthcare mean? Healthcare is a broad field involving many actors, complex relationships and complicated legislation. In the same vein, competition law compromises a sophisticated set of rules geared towards fostering competition in a wide array of markets and towards balancing various objectives and interests. What are the ramifications of applying competition rules to the various healthcare operators? Mary Guy has explored with great care these ramifications by focusing on the essential characteristics of the healthcare systems of the United Kingdom and the Netherlands.

An important component of Mary Guy's study is that the rationale of the British and Dutch healthcare reforms is explained. It is an understatement to say that these reforms are complicated and hard to understand for an outsider. The insights offered in this book are very helpful to getting a better grasp of the effects of competition on healthcare and of the way that competition law is applied to healthcare cases. Of great interest is the interplay between the general competition rules and the healthcare specific competition provisions. It is illuminating to learn which difficulties are caused by this interplay in both the United Kingdom and the Netherlands.

A very important issue raised by Mary Guy is the aim of universal access. Is enhancing competition in healthcare an end in itself or does it serve another cause? In the European approach to healthcare it is commonly accepted that the policies adopted by the governments must aim at giving every citizen access to healthcare. Introducing competition must contribute to achieving this goal, which, of course, means that it is not an end in itself. This finding makes clear that applying competition law to healthcare also implies that the various interests at play must be balanced.