Would Roman Soldiers Fight for the Financial Flows Regime? The Re-issue of Diocletian's Edict in the English NHS

Abstract

Some 17 centuries after the Roman Emperor Diocletian attempted to set prices across the Roman Empire, a system of national prices (tariffs) is being introduced to the English National Health Service (NHS) to enhance patient choice. Initially, fixed prices will apply to 15 treatments. Costs for these treatments as reported by all NHS providers are examined to ascertain whether the data provide a robust basis for price setting. If prices are calculated such that providers are unable to recover the true costs of efficient service provision, considerable financial disruption could result for no good purpose. The authors explain the lessons that should have been learned from the Roman experiment and the changes that need to be made to avoid repeating the mistakes of the past.