IS REASONABLE ACCESS WHAT WE WANT - IMPLICATIONS OF, AND CHALLENGES TO, CURRENT CANADIAN POLICY ON EQUITY IN HEALTH-CARE

Considerations of equity in the context of health care systems are oft en related closely to the presence or level of prices incurred by user s of health care services. Some politicians and commentators have sugg ested that the removal of user charges under the Canadian health care system has led to equal access to care. But it is not clear that the e quity principle inferred from these claims corresponds to the equity g oals of current Canadian health policy. In this article the authors id entify the precise equity principle that lies behind current health po licy in Canada and consider the extent to which that principle is refl ected in the performance of the system. They then consider other appro aches to equity in health care in the context of the stated objectives of Canadian health policy and identify the implications of pursuing r easonable access in future health policy. The authors suggest that the implications of the current equity goals have not been recognized by policy makers, and if they were to be recognized it is not clear that they would be acceptable to Canadian populations and/or policy makers. Moreover, some of the implications would appear to be incompatible wi th other stated objectives of public policy.