It is an interesting aspect of the current debate with regard to healthcare in developed countries that the discussion starts with the finance of healthcare. What makes it interesting is that, with the exception of the US, healthcare is predominantly financed by government through a combination of a social welfare contribution and general taxation. There is some private financing through private insurance, but tax benefits for insurance and the universality attaching to most public systems effectively means that the government is financing health expenditure. In almost no other area of Government expenditure would we be considering the question of financing as financing is simply a function of taxation. The question of financing healthcare is thus a deeper one than simply that of financing and owes its origin to the rapid growth of expenditure on healthcare over the past 30 years, and the realisation that as population ages, claims on resources will increase over the next 30 years. the finance of healthcare is in fact a topic which is not really about finance, but about the means that can be used to control expenditure to ensure that taxes do not have to be raised. This paper examines the causes of the growth in healthcare expenditure in Ireland and, with the framework developed there, discusses measures designed to control expenditure.