On The Quiet Power of National Decisions: Hospitals, State Aid, and Services of General Economic Interest
Year: 2025
Type: article
Abstract: The extent to which EU competition law applies in the healthcare context remains a contested question. The contemporaneous publication of the European Commission's Evaluation of State Subsidy rules for health and social services of general economic interest (SGEI) in December 2022, and of the Court of Justice of the European Union's April 2023 judgment in Casa Regina Apostolorum regarding state support to hospitals in Italy, underscore uncertainty and appear to indicate an impasse. These publications unfold against the backdrop of two tensions: between state and market, and between the EU and national levels. Hospitals illustrate these tensions well due to the expansion of competition mechanisms into the hospital sector (notably expanding private provider delivery of public hospital services, often supported by "patient choice" policies), and of hospitals remaining typically local or regional in character rather than supranational. This article provides a timely and original analysis of the Casa Regina Apostolorum judgment in light of Commission policy regarding SGEI and hospitals and how EU Member States engage with this. It offers insights into the potential legacy of Casa Regina Apostolorum, and indicates where future legal challenges may focus.
Author: Mary Guy
Institution: Liverpool John Moores University
Language: English
Topic: EU Law and Policy Analysis
Subfield: Law
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,550
Awards: G4431698691, G8867592346
OpenAlex ID: W4412585484