Contributions to health care should be tax based and progressive. A single insurer is preferable, but in the absence of one monopoly insurer, insurance funds should be faced with incentives to limit total health care expenditure and to allocate resources to maximise the benefits from expenditure. Third party payers should be accountable to their contributors and also to the community for assurance of access, quality of care and cost constraint. Inability to pay should not be a barrier to the use of health care services. The objectives of health care are complex and encompass more than clinical outcomes.
Efficiency is an important objective of health care.
Value for money is best achieved when patterns of resource allocation with respect to particular agencies and programs are determined in a way that takes into account the needs and existing patterns of service of identified populations and which contribute to the achievement of agreed priorities. Information on the benefits, risks and costs of health care interventions is a necessary pre- requisite for efficient health care. Consumers can contribute collectively to determining health system objectives and to setting priorities. Different forms of remunerating providers give different incentives and therefore have different advantages and disadvantages. For example, higher service use is associated with fee for service.