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KMID : 0904520070200010073
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Health and Medical Sociology
2007 Volume.20 No. 1 p.73 ~ p.103
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Health Care Priority Setting: the UK Case and its Implications
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Im Mun-Hyuk
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Abstract
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In the participatory government, strengthening the security of health insurance has become a significant issue in health policy making. Strengthening the security of health insurance by means of enlarging the health insurance benefit package through rational priority setting in health services is a task Korea’s health insurance is currently confronted with. However in contrast to the developed countries, where research in this area has been strenuously conducted, little has been done in the research field in Korea. Therefore it is necessary to learn from foreign case studies, as this will contribute to health policy making in Korea.
In this context this paper aims at finding policy implications suited to Korea’s situation by carefully analyzing the case of health priority setting in the NHS. Major characteristics setting priorities in Britain are the importance of cost-effectiveness and efforts to reflect the public’s view in policy making. Additionally the NHS has pursued to end the postcode lottery caused by continuation of respect for the autonomy of purchasers in their local priority setting, by establishing NICE.
What can we learn from Britain?
Firstly, in order to build a system in which the public is provided with effective treatments and cost-effective services, the establishment of an organization, which draws up guidelines for the supply of such health services, and a monitoring organization, which ensures these guidelines are followed in the process of supplying health services to the public, is necessary.
Secondly, when setting priorities, it is desirable to set priorities according to the professional view of doctors which is most important. In addition, efforts to reflect the public’s view in priority setting are also needed. To elicit public opinion effectively, it is necessary to adopt citizens’ juries, where sufficient information and time is given before the public decides on priority setting. Also as it seems highly likely that some disagreement on priorities between doctors and the public will be revealed, how policy makers can dissolve this disagreement between the two groups will be an important issue.
Lastly, this paper discusses the sector of priority setting where social concurrence is needed.
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KEYWORD
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NICE, Security of Health Insurance, Priority-Setting, Cost-Effectiveness, Public Involvement
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