Setting priorities New Zealand-style

What is the best way to ration health services? We have had debate: between those who argue that the government should define a package of services available on the NHS1 and those who instead prefer fuzziness–leaving rationing decisions largely up to clinicians.2 But whatever the services available, there is general agreement that more could be done to ensure that effective treatments are provided. The approach taken by the British government has been mixed. On the one hand it has decided not to define a list of core services available on the NHS and has left it up to purchasers to decide.3 To help, it has provided information to purchasers on the effectiveness of a range of treatments.4 On the other, it has developed several policies with direct bearing on rationing, such as curtailing free eye testing on the NHS, allowing adult dentistry to drift out of the NHS, and requiring purchasers to …