overall strengthening competition in the health care sector if accompanied by appropriate regulation has the potential of increasing the sector s resilience to shocks by lowering spending pressures effective regulation seems to be paramount as market forces if unchecked are likely to result in overprovision of health care services especially in periods of economic bonanzas and reduction in coverage and services at least for some part of the population during recessions regulated competition can also better align health care service characteristics with patient preferences allows for the setting and enforcing qualityofcare standards promotes access to care with for instance meanstested subsidised insurance premiums and strengthens incentives to achieve efficiency gains wellregulated systems can yield cost savings and help ensure an adequate level of care but getting the regulatory setting right has proved to be challenging