This document summarizes evidence on incentivizing competition in public services like healthcare. It finds that separating healthcare provision from funding through insurance schemes can introduce competition but consolidation limits its effects. Prices set prospectively for hospitals may increase quality and activity. Limited evidence shows negotiated prices between insurers and providers can decrease quality. More autonomy and control over surpluses for providers is associated with better outcomes but regulations often erode such autonomy. Competition among family doctors with limited cost sharing can increase satisfaction and quality to a small degree. However, strong consolidation trends and heavy regulation limit meaningful competition in many European healthcare systems.