Intended for healthcare professionals

Head To Head

Should there be a ceiling on what percentage of GDP countries spend on health? No

BMJ 2008; 337 doi: (Published 25 September 2008) Cite this as: BMJ 2008;337:a1036
  1. Werner Christie, former minister of health
  1. 1Vidarshov gård, 2322 Ridabu, Norway
  1. werner{at}

    Demands on healthcare budgets seem to be ever increasing. Nick Bosanquet (doi:10.1136/bmj.a1040) believes it is time to limit spending, but Werner Christie argues that it should reflect medical needs not economic performance

    There are several good reasons for not fixing health spending to a varying gross domestic product (GDP). The funds we choose to allocate to health care should reflect the comparative value that a health service represents for the population in relation to needs of other sectors, rather than GDP. The progress of medical science and an ageing population may increase both the relative benefit and cost of health care, requiring greater expenditure. Health care is labour intensive and therefore its costs may increase more than those of other sectors of the economy that can more easily improve productivity through automation and technological progress, making current distribution of funds inappropriate.

    Health spending should reflect medical needs not unstable economic trends. Although suboptimal effectiveness and efficiency may justify temporary caps in further spending to provide necessary pressure for improvements and incentives to reduce …

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