ABSTRACT
Introduction One of the distinguishing characteristics of the British system of healthcare is the relatively high proportion of total spending that is publicly financed and, conversely, the relatively small share that is privately funded.1,21 This character istic is in common with most of Scandinavia and other countries that have taxfunded national health services, but in sharp contrast with those of European and other countries which have more pluralistic, social insurance-based systems, as well as that eccentric example of exceptionalism - the United States. The percentage ratio of public and private spending is 83:17 in the UK as against 69:31 in the Netherlands, 70:30 in Australia and Canada, and 76:24 in France and Germany. Indeed, if public expenditure on healthcare alone is considered, in 1998 the UK government was already close to achieving its target of matching the EU average level of spending, i.e. even before the Prime Minister, Tony Blair, committed it to a dramatic expansion in the rate of spending in January 2000. UK public spending on healthcare in 1998 represented 5.7% of gross domestic product (GDP) as against the unweighted EU average of 5.9%. Given the acceleration of public spending since then, the UK is not so far off the higher, weighted EU average of 6.4%. If Britain still appears to be a laggard in terms of healthcare expenditure, and if the funding issue dominated decisions and debate in the Chancellor of the Exchequer's budget in 2002, it is in large part because private spending remains conspicuously lower: 1.1% of GDP as against an EU average of 2.0% (unweighted) or 2.1% (weighted).
