Severino Sterpi

Equity and equality in health care and health are aims that pertain to a specific sphere of justice. Equity in health care (same cares for the same needs) is a hard goal because of a series of factors that differentiate the real access to the providers (i.e. the personal revenue and culture). Otherwise, equality of health is an impossible and non recommendable aim even in case of equity of access, because of the biological, irreducible differences between individuals, and the role of the individual utility functions. Public policies towards the best conceivables states of equity and approximate equality of health must frequently trade-off between equity and allocative efficiency. At the micro level, the possible improvements in the efficiency of providers and in the contractual relationships between patients, providers and insurers could free resources and avoid selections of patients and cares that are very difficult to accept on the ethical and political ground.