Eleven percent of the U.K. population holds private health care insurance,
and £2.2 billion are spent annually in the acute sector of private
health care. Although isolated from policy discussions about new medical
technology in the National Health Service, the private sector encounters these
interventions regularly. During 18 months in one company, a new medical
technology was encountered on average every week; 59 leading edge technologies
were submitted for authorization (18 on multiple occasions). There are certain
constraints on purchasers of health care in the private sector in dealing with
new technology; these include fragmentation of the sector, differing
rationalities within companies about limitations on eligibility of new
procedures while competing for business, the role and expertise of the medical
adviser, and demands of articulate customers. A proactive approach by the
private sector to these challenges is hampered by its independence. Poor
communication between the public and private sectors, and the lack of a more
inclusive approach to policy centrally, undermine the rational diffusion and
use of new medical technology in the U.K. health care system.
An experimental investigation of mixed systems of public and private health care finance
