Some of the most important questions in assessing the impact of private medicine in Britain relate to distributional issues. Who ‘goes private’ and why? If some groups benefit from the growth of the private sector do others lose out? Does private medicine contribute to an overall increase in health care resources or does it lead simply to a redistribution of existing resources and a readjustment of priorities by default? Many of these questions are impossible to answer conclusively because of large gaps in current knowledge about the private market and about its impact on the NHS. The balance sheet of gains and losses can only be drawn in a rudimentary fashion. This chapter focuses upon the winners and losers in the battle for health care — both in an individual and an institutional sense.
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