Rising concerns over costs, transparency and competitive dynamics in private healthcare have prompted Competition Commission of Mauritius to launch its first-ever market inquiry. Its Executive Director here explains the rationale behind this unprecedented exercise and what it could mean for competition, regulation and patient outcomes.

? Competition Mauritius has launched its first-ever market inquiry under Section 51B of the Competition Act in the private healthcare sector. What market failures or warning signals convinced you that routine regulatory oversight was no longer sufficient and that a structural inquiry had become necessary?

Let me before answering your question briefly clarify the main difference between a market study and a market inquiry. In conducting market studies, we rely mostly on publicly available data and voluntary commitment of stakeholders to provide us with relevant information for conducting our competition assessments. The new market inquiry regime now gives the Executive Director formal powers to engage with stakeholders and compel production of information; ensuring that market inquiries produce accurate and thorough findings for evidence-based policy recommendations or enforcement actions.

Coming back to your question, it is important to highlight that the Executive Director can only launch a market inquiry provided he has reasonable grounds for suspecting that any feature, or combination of features, of any market in Mauritius prevents, restricts or distorts competition in connection with the supply or acquisition of any goods or services in Mauritius.

This test was met in the private healthcare sector where market competition may be impeded by structural and behavioral features. These include high levels of concentration across the private healthcare supply chain and imbalances in bargaining power amongst operators impacting on costs of treatments; lack of transparency and information asymmetry on pricing of medical procedures and success rates affecting patient choice; financial incentives to doctors steering referrals and potentially leading to over treatment; and preferred-provider networks by medical insurance providers potentially foreclosing patient access to smaller clinics.

The issues identified may adversely affect competition and market outcomes for patients in terms of fees and charges for medical procedures and associated services. The market inquiry has only just been launched, and the process has to run its course before conclusive findings are made.

? You have pointed to problems of transparency in pricing and in the performance of healthcare providers. To what extent do you believe the current opacity over prices and quality distorts patient choice and may reflect deeper competition failures in the market?

It is important to highlight that medical care involves critical services that are not comparable to standard consumer products or services where buyers are the ones choosing the goods they consume. When it comes to healthcare, patients rely heavily on medical professionals to determine the appropriate diagnostic tests and treatments, particularly in private clinical settings. This asymmetry of information is compounded by a lack of transparency on fees and charges across private clinics. As a result, patients are often unable to effectively compare options both in terms of costs and quality of care. This limits their ability to make informed decisions and increases the risk of overcharging, ultimately undermining trust and efficiency in the healthcare system.

? One sensitive issue concerns the high –and at times uniform– level of fees for certain private healthcare services. Will the inquiry also seek to determine whether there are risks of collusion, tacit coordination or parallel conduct among operators that may run counter to effective competition principles?

The market inquiry will assess, amongst others, concentration levels, pricing behavior and arrangements amongst the various operators in relation to the supply of private healthcare services and their impact on competition. Concerning price behavior, a comparative analysis of fees and charges across the various private clinics will be conducted. In this regard, it may be important to develop standardized metrics to compare medical services based on models adopted in other countries regarding disclosure on prices and success rates for medical procedures. As I mentioned, a market inquiry can also provide basis for ensuing enforcement actions against one or more market operators. If the price analysis raises reasonable grounds to believe that any restrictive practice is occurring on the part of operators, I will launch a formal investigation into the matter under the Act.

? Past attempts to regulate or rationalize private clinic costs have often run into significant resistance and lobbying pressures. What makes you believe this initiative now has a greater chance of leading to concrete change?

A market inquiry allows the Competition Commission to move beyond anecdotal concerns and build a clear, evidence-based understanding of how a sector functions–where the inefficiencies, information gaps, and distortions in competition lie, and how they affect prices, quality, and patient choice. This provides a much stronger foundation for recommending targeted and practical reforms to the regulatory framework.

Equally important is the transparency of the process. Market inquiries involve stakeholder consultations and culminate in the publication of findings and recommendations. This openness not only strengthens the credibility of the exercise but also fosters informed public debate and accountability. Taken together, these elements significantly improve the likelihood that the outcome for the private healthcare sector will translate into meaningful, implementable changes that promote fair competition and better outcomes for patients.

? Beyond diagnosis, how do you ensure this inquiry does not remain just another consultative exercise? Are you aiming ultimately for policy recommendations only, or also for corrective and enforcement actions capable of materially changing how this market operates?

The Competition Act gives the Competition Commission a clear mandate to go beyond market diagnosis. Following a market inquiry, we can issue targeted policy recommendations or, where warranted, initiate enforcement action based on the findings. Our recommendations are not merely conceptual –they can address concrete regulatory, legislative, or policy gaps that may be hindering effective competition.

When implemented, these measures can remove structural barriers, improve transparency, and create the conditions for more competitive outcomes. Experience from other jurisdictions illustrates the potential impact. In South Africa, for example, a market inquiry into mobile data services led telecom operators to reducing their mobile data prices and implementing transparency measures to regularly inform customers of their data usage and pricing. This ultimately contributed to overall lower prices and more effective competition between the mobile network providers. So, the objective of our market inquiry is very much to ensure that this exercise leads to tangible change –whether through reforms to the framework or direct enforcement interventions that reshape how the market operates.

? Some may argue that the issue in private healthcare is not only one of competition, but also of concentration of market power. Could this inquiry reopen debate about the structure of the sector itself and the influence of certain dominant groups?

High levels of concentration, particularly when combined with barriers to entry, can create conditions where market power may be exercised to the detriment of consumers. The role of the Competition Commission is to assess these structural dynamics and determine whether market outcomes are distorted. Through market inquiries, investigations, and studies, we examine whether the structure of the market –and the conduct of firms within it– supports or undermines effective competition. While dominance in itself is not prohibited, its abuse can trigger competition intervention and ensuing corrective measures.

In this context, the private healthcare inquiry can help inform the debate on the structure of the private healthcare sector, including issues of concentration and market power. Where evidence points to restrictive business practices, the Commission will not hesitate to pursue investigations and take appropriate enforcement action.

At the same time and as previously mentioned, the publication of findings will also enhance transparency, enabling stakeholders and consumers to make more informed decisions–another key lever in strengthening competitive pressure in the market.