Politics & Policy

The problem with single-payer healthcare systems with fixed budgets like the U.K.'s National Health Service is that they are zero-sum games: to pay for one new drug that comes on the market, something else has to give. The stresses on the system are beginning to show, as patients and companies are starting to fight back in court and in the media against NHS and NICE.

The National Institute for Health and Clinical Excellence, which has become the arbiter of coverage by the nationalized scheme, originally was set up as an independent organization responsible for providing national guidance. But many stakeholders affected by NICE's recommendations no longer believe the agency is independent. Rather, they see it as an agent of government tasked with deciding when the NHS should say "no" to treatments that patients want...