Health sector financing reforms that have been ongoing over the last decade in most developed countries are rooted in philosophical terms in the ideology of economic rationalism. The ideology suggests that it is possible to artificially create markets for activities in contexts where markets do not develop naturally, and that the creation of these artificial markets leads to resource allocations that are both more efficient and more equitable than historical arrangements. The application of the ideology to New Zealand's health sector (...) has generated some benefits—for example, a more rational approach to influencing the decisions of self-interested health care providers; but it has also generated some costs—for example, on ideological grounds it has brought into question the non-market rationales for maintaining a national health service system. (shrink)