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Rob: Thanks for weighing in. On performance-based financing, this is exactly the kind of schemes that need to be introduced to strengthen accountability of service providers in the absence of user fees, which is what we're advocating. Your experience and anecdotes are valuable, but we have yet to see evidence on public v. private systems of care that answer the simple question we posed in the blog: If the same patient with the same symptoms went to different providers, what would be the accuracy of treatment received? We would welcome any reference you may have. The image of the poor woman with a sick child is evocative, but is tangential to our blog post. We are not advocating private financing. We say two things: (i) evidence of increased use is not evidence of improvements in outcomes (and we suggest why this is so); and (ii) when eliminating prices as an accountability mechanism, something needs to replace them. This could be a variety of systems, so we need to experiment, learn and tweak before deciding on one system.