Health policy - The Kartellamt prohibits hospital alliance - The state plans to continue
The German Federal Cartel Office has prohibited a partnership between the Universities Hospitals of Heidelberg and Mannheim. After a lengthy investigation, the authority concluded that the anticipated disadvantages, primarily for patients and patients, outweigh the potential advantages.
The state intends to apply for a ministerial permit at the Federal Ministry of Economics to consider aspects such as market dominance, healthcare, top-level research, and urgently needed medical study places.
Baden-Württemberg and the city of Mannheim aim to form a union of houses to keep the high-deficit Mannheim location and create a "European beacon project of medicine," as Mannheim's former mayor Peter Kurz (SPD) formulated last year. The state is the sponsor of the Heidelberg site, and the city of Mannheim is the local university clinic sponsor.
The state declared:
"We are still convinced of the necessity and significance of the desired merger from an economic and medical-strategic perspective and above all due to our social responsibility for the best possible care for patients and patients."
The cartel law is not designed to consider the unique aspects and challenges of a merger of two such large university clinics and the potential loss of medical peak research, high-level patient care, and approximately 270 medical study places in the event of a prohibition.
In the desired merger, both hospitals were planned to closely collaborate on medical, economic, and scientific levels without losing their independent profiles. There are a total of 2,000 study places for human medicine in Mannheim alone. The Universities Hospital Heidelberg was planned to become the majority shareholder of the Mannheimer Uniklinik.
The President of the Federal Cartel Office, Andreas Mundt, stated that the competitive disadvantages resulting from a merger would primarily affect patients and patients, as "in the region, there remain only a few comparable and independent competitors besides those involved in some medical specialty areas, almost none at all."
If significant providers became part of the same holder, the quality competition would be lost, as there would no longer be the same need to fear departures to the competition.
The Federal Cartel Office also considered the parties' argument that size, higher patient volumes, and specialization often lead to better treatment quality. "However, we do not assume that the merger is necessary to achieve this benefit. Other forms of cooperation can produce similar positive effects without taking away the clinics' independence."
The Federal Cartel Office analyzed the performance spectrum and patient origin of more than 320 hospitals within a radius of approximately 150 kilometers around Heidelberg and interviewed 30 hospitals and 215 general practitioners and specialists in the region.
The decision is not yet legally binding. A complaint can be filed at the Düsseldorf Higher Regional Court.
The city is "at the limits of its financial capabilities."
The intended partnership is still the right way, according to Health Minister Manne Lucha (Greens), for needs-based and high-quality healthcare provision in the entire Rhine-Neckar region. I therefore support the necessary way through a application at the Federal Economic Ministry to achieve these goals.
Mannheim University Hospital is incurring high losses - losses so high that the state has had to provide significant funding since 2021. The hospital expects a deficit of 99 million Euros for 2025, as stated by Mayor Christian Specht (CDU): "The financing of a Supra-Maximal Hospital, which provides women and men not only from the region but from all of Germany with highly specialized medical services based on scientific excellence, is putting increasing strain on our city's financial capabilities."
Heidelberg University Hospital, as previously stated, has approximately 2,600 beds and around 86,000 stationary and over one million ambulant patients per year. With 10,700 employees, it is one of the most important employers in the region. In Mannheim, around 4,300 employees work. They treat nearly 45,000 stationary and over 170,000 ambulant patients.
- The Federal Cartel Office, headed by President Andreas Mundt, has prohibited the partnership between the Universities Hospitals of Heidelberg and Mannheim.
- The Federal Ministry of Economics will consider various aspects in the state's application for a ministerial permit, including market dominance and healthcare.
- Baden-Württemberg and Mannheim aim to form a union of houses to save the Mannheim location and contribute to European-level medical research.
- The Federal Cartel Office concluded that the potential advantages of the merger are outweighed by anticipated disadvantages, primarily for patients.
- In the prohibited merger, both hospitals planned to collaborate closely on medical, economic, and scientific levels, while maintaining their independent profiles.
- The cartel law may not fully consider the unique aspects and challenges of a merger between two large university clinics, potentially leading to lost medical research and study places.
- The city of Mannheim, as the local university clinic sponsor, is facing financial limitations due to the mannheim University Hospital's high losses, necessitating significant state funding since 2021.
