The paper deals with the problem of „rationing“ expensive care which is connected with the necessity of selecting patients because it is not possible to provide that care to all of the patients who could be clinically benefited by it, be it for insufficient capacity of the facility, financial or other reasons. In a series of interviews with the heads of selected departments providing super-specialized healthcare there has been discussed the current situation from the point of view of changes connected with the transformation of healthcare with special emphasis on the impact of changes in financing since 1997. Further, there has been discussed the problem of selecting patients, the transparency of allotting care and the interference of non-clinical aspects into the process of that allotting. The providing of healthcare proceeds on the basis of applying explicit as well as implicit criteria.Among the explicit ones it is first of all clinical characteristics that assert themselves. Except for minor exceptions the situation at the time of the survey (year 2000) was assessed positively from the point of view of rationing, without any marked signs of disproportions between clinical need and available capacities. Such evaluations are probably influenced to a large degree by continual comparisons of current possibilities with the situation preceding the year 1989, however, it cannot be ruled out that the need of super-specialized healthcare is very under-dimensioned due to bad coordination of services at lower levels of the healthcare system and the „holding up“ of patients in primary and out-patient specialized care.

        Key words: modern technologies - costs - rationing - explicit and implicit rationing.