The Dutch health care system has been described as a 'patchwork quilt'. It is a complicated system that has evolved from a constant adding and changing of institutions, regulations and responsibilities. Every citizen of the Netherlands has an entitlement to health care. The government authorities in the Netherlands have focused on creating favourable conditions in which the already existing private sector could expand or improve services. Although health care is provided largely through private institutions and practitioners, the system is considered to have a high degree of regulation. Until the 1980s, the Dutch health care authorities had no clearly defined philosophy of controlling the development and use of health care technology. Since the mid-1980s, however, a number of initiatives have been taken, policy instruments for controlling technology have been used in a more coordinated manner, and health Care technology assessment has developed rapidly. The immediate future will see increasingly explicit use of the benefit package to control introduction of new technologies, as well as a growing influence of technology assessment itself.