Luxembourg's public health insurance is a compulsory insurance
for all employees, self-employed professionals, farmers, and
pensioners. It is financed through contributions of the insured
people, as well as by state taxes. Providers of health care are
mainly private nonprofit institutions and self-employed
professionals. All healthcare procedures are defined in fee
schedules determined by a common decision of the Ministers of Social
Security and Health according to proposals of a board of experts. The
relative value of a service is also determined by the corresponding
fee schedule. Hospitals are financed by individual budgets
negotiated between each hospital and the health insurance. These
hospital budgets do not cover services provided in hospitals by
medical specialists, who are reimbursed on a fee-for-service basis. A
law on hospital planning and organization allows the government to
restrict the installation in hospitals of very expensive equipment or
of equipment for which there is only a limited need in Luxembourg
hospitals. Until recently there has been limited interest in or use
of health technology assessment (HTA). However, large hospital
investments have provoked some interest in the last few years. The
Ministry of Health has asked for some HTA studies when a concrete
decision had to be taken. Luxembourg decision makers have become
more aware that HTA may help them to become more informed about the
short- and long-term consequences of the application of health
technology.