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As the healthcare sector grows in significance due to social and technical developments the EU competition rules are likely to be more frequently applied to healthcare both as a result of the broad interpretation of the concept of undertaking and because the applicable antitrust rules are since modernisation also applied at Member State level. At the same time there is so far little guidance regarding the manner in which the substantive rules must be applied. This problem is less serious concerning state aid where the beginnings of a framework exist, in particular in the form of the Altmark test and the services of general economic interest (SGEI) concept, and where enforcement remains largely centralised in the hands of the Commission. We plead for a broader application of SGEI and of the legitimate objective test that is found in Wouters and Meca-Medina. In particular we advocate providing guidance by means of a soft law approach within the European competition network (ECN).

Taking the Temperature: A Survey of the EU Law on Competition and State Aid in the Healthcare Sector