"YIKES". Marginal Revolution points to a problem in Britain's National Health service. Patients have been paying extra for treatments not covered by the NHS, while still getting the majority of their treatment on the government's dime. Now the NHS is cracking down.

"Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament."

The article is about an important problem for public health systems: politically, they find it very hard to tolerate any inequality of access to treatment, but even harder to finance all the treatment people might demand, or to forbid rich people to take life-saving actions. But it hints at another problem for Europe's health care systems. It strikes me that for a long time Europe managed to keep its health care costs down because patients had relatively little information. Governments therefore found it fairly easy to set the standard course of treatment using some sort of crude cost-benefit analysis. But differences in systems, plus the internet, mean that cancer patients now know there is an Avastin--and you will have hell to pay if you deny it to them. Browbeating the pharmas will not generate enough savings to finesse this trend.