ABSTRACT

Priority setting began in the wake of proposals to reform an insurance-based system of health care. In 1990, the Dunning Committee was appointed to advise on how priorities should be set; however; before it could report, the government decided to include 95% of existing services in the basic care package. Dunning also proposed controls over the introduction of new technology. Dunning suggested that controls be extended so as to favour the development of new technology for the chronic sick. Since 1987 The Netherlands has established its own Fund for Investigational Medicine (MTA) to provide information about the benefits and costs of new technologies. A poll commissioned by the Dunning Committee found that the majority of the public were opposed to any restrictions on treatment, even the most expensive ones. Dunning presented an instrument for priority setting and strongly recommended the Cabinet to apply the method in order to have a restricted basic package.