Cost effectiveness establishes how much extra has to be paid for extra benefit. It can be expressed as the ratio of marginal cost to marginal benefit—the incremental cost effectiveness ratio (ICER)Sir William Beveridge, who in 1942 set out the blueprint for the NHS, wrote: "The first principle is that any proposals for the future, while they should use to the full the experience gathered in the past, should not be restricted by consideration of sectional interests established in the obtaining of thatexperience." Sectional interests are trying to defeat long overdue healthcare reform in the US, as they have tried to outflank NICE in the UK.
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