Since the introduction of the Impanian National Health scheme, Impanians (or their private insurance companies) have had to pay only for the more unusual and sophisticated medical procedures  When the scheme was introduced, it was hoped that private insurance to pay for these procedures would be available at modest cost, since the insurers would no longer be paying for the bulk of health care costs, as they had done previously
Paradoxically, however, the cost of private health insurance did not decrease but has instead increased dramatically in the years since the scheme' s introduction
The proportion of total expenditures within Impania that is spent on health care has declined since the introduction of the National Health scheme.