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Should there be a ceiling on what percentage of GDP countries spend on health? Yes

BMJ 2008; 337 doi: (Published 25 September 2008) Cite this as: BMJ 2008;337:a1040
  1. Nick Bosanquet, professor of health policy
  1. 1Imperial College, London SW7 2AZ
  1. n.bosanquet{at}

    Demands on healthcare budgets seem to be ever increasing. Nick Bosanquet believes it is time to limit spending, but Werner Christie (doi:10.1136/bmj.a1036) argues that it should reflect medical needs not economic performance

    From 1990 to 2005, health spending in real terms rose almost twice as fast as gross domestic product (GDP) across countries in the Organisation for Economic Cooperation and Development—4.5% compared with 2.5%. This is unsustainable in an era of lower growth as the UK government, for example, says it has reached the limits of taxable capacity. A new approach is therefore needed. For the UK and for much of old Europe it would be strong and timely discipline to plan for health spending to increase at the same rate as GDP for the next five years. This would send a message that the key challenge is to get more value from the vast sums of money currently being spent on health services.

    Apart from the United States, most …

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