Introduction In the past decades, several aspects of priority setting in health care have been addressed, but relatively little attention has been given to the question of its effectiveness. There may be several reasons for this, including the significant methodological challenges associated with such endeavor. However, raising the effectiveness issue could still be worthwhile. It could engender a debate as to what, exactly, is or is to be pursued by priority setting in health care, and it might increase our understanding of underlying mechanisms or preconditions for priority setting to work well.

Methods A review of policy analyses of the effectiveness of priority setting at the national level in the Dutch health care system.

Results As part of a wider evaluation, a recent study has shown that so far, governmental influence on the composition of the benefit package has been small. In addition, the National Accounting Office has shown that explicit priority setting has had only minor impact on the financial sustainability of the health care system. Finally, the Scientific Council for Government Policy has shown that the way resources are being spent results only to a small degree from explicit policy decisions. It argues that quality and accessibility of certain health care sectors (e.g., mental health, youth care) are insufficient, calling for more forceful explicit priority setting.

Conclusions Research into the effects of priority setting at the national level in the Dutch health care has been sparse, and rarely explicitly addresses equity issues. Such research could further advance the field of priority setting, particularly if priority setting were conceived as a practice, a practice that requires a culture of priority setting, and v.v.