The regulatory principle of competition has been regarded as the ultimate remedy since the mid-1990s in efforts to ensure efficient and high-quality care in statutory health insurance (GKV). However, to avoid distortions such as risk selection or underprovision, the competition-oriented approach requires significant accompanying regulation. Using the framework of New Institutional Economics, Martina Samwer examines three different regulatory approaches aimed at achieving an optimal balance between competition and solidarity-financed, high-quality healthcare: the design of an optimal liability law following the introduction of the DRG reimbursement system; the application of procurement and competition law to the purchasing behavior of health insurance funds; and the optimal structuring of contracts for integrated care.