The Portuguese healthcare system is often portrayed as a NationalHealth Service (NHS) model, characterized by universal coverage, comprehensive benefits, nearly free services, national tax financing, andpublic ownership or control of the factors of production. However, inreality the system fails to accomplish these features in a completeway. There coexist a number of occupation-related healthinsurance schemes that were originally intended to be integrated intothe NHS. In addition, in key areas the NHS does not provide the widerange of services it promises. The public sector has a predominantrole in the provision of hospital stays and general practitionerconsultations, but the private sector provides a major portion ofspecialist consultations, dental consultations, and diagnosticservices. Major problems in the system led to health reforms in the1990s. New reform proposals include some specific steps concerninghealth technology, including standards for medical equipment based onquality, geographic distribution, sustainability, andcost-effectiveness. A new National Plan of Health Equipment wascompleted in 1998, aimed at improving the distribution of equipment.Despite reforms, healthcare expenditures continue to rise. There is general agreement that gains in efficiency could be made. Thissituation is beginning to encourage interest in healthtechnology assessment (HTA) in Portugal, although these activitiesare not yet very developed. Recently, legislation requiring presentation of economic evaluations for new pharmaceutical productswas enacted. Present plans also call for the creation in the future of a national agency for HTA.