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Health care rationing has always been seen as a wicked problem, somehow special and not subject to the same rules of engagement as other policy areas. The article by Philip Sax makes a strong contribution by placing one prominent part of rationing, determination of a national drug formulary, into the larger political economy context of Israeli policy making. While one can argue with some of Sax’s implied conclusions, his analysis provides a great platform not only to understand governance of this difficult area, but also to better govern in the future.

Governing the allocation of scarce resources: is health care no longer a special case?