I sådanne systemer er der en vis grad af konkurrence mellem hospitaler med hensyn til udbud af sundhedstjenester. Når det er tilfældet, er det forhold, at en sundhedstjeneste ydes af et offentligt hospital, ikke tilstrækkeligt til at klassificere aktiviteten som ikke-økonomisk.«
OJ C 8, 11.1.2012, p. 4: ‘In many other Member States, hospitals and other health care providers offer their services for remuneration, be it directly from patients or from their insurance. In such systems, there is a certain degree of competition between hospitals concerning the provision of health care services. Where this is the case, the fact that a health service is provided by a public hospital is not sufficient for the activity to be classified as non-economic.’