Competition Commission Highlights Pricing Opacity in Private Health Insurance

The Competition Commission has identified significant opacity in the pricing mechanisms within the private health services and health insurance sectors, stemming from a recent sectoral study. This comes in the wake of a contentious rise in health insurance premiums earlier which prompted governmental intervention to control price hikes through legislation. The law enacted in 2025 mandates the Hellenic Statistics Authority (ELSTAT) to develop an Annual Adjustment Index that will regulate premium increases starting in 2026, alongside obligations for private providers to disclose detailed service pricing and costs of medical supplies.

Despite regulatory efforts, the Commission questions the effectiveness of these measures and whether they align with broader competition rules. The report does not find evidence of oligopolistic structures or significant entry barriers but highlights that market consolidation through acquisitions by insurance companies is neutral in itself, warranting scrutiny only on an individual basis.

A central cause of opacity is the role of intermediaries in driving demand for private health services. Often, demand is influenced by personal physicians and insurance companies via pricing and coverage agreements rather than patient choice, leading to "induced" demand where unnecessary medical tests and services are prescribed. This practice inflates costs and benefits providers financially, reinforcing non-transparent pricing dynamics.

The report underscores the financial incentives for doctors and diagnostic centers to engage in reciprocal arrangements, thereby increasing patient visits and procedures primarily for profit rather than clinical necessity. These findings showcase the complex interplay between providers, payers, and regulators in shaping pricing transparency and competitive practices in private health insurance markets.