Resource allocation within Australian indigenous communities: A program for implementing vertical equity

Given the significant disparities in health and health related disadvantage between Aboriginal and non-Aboriginal Australians, the application of some notion of equity has a role to play in the formulation of policy with resp ect to Aboriginal health. Aboriginal and Torres Strait Islander has been ab breviated to Aboriginal. There has been considerable debate in Australia as to what the principles of equity should be. This paper discusses the relev ance of the principle of vertical equity (the unequal, but equitable, treat ment of unequals) to Aboriginal health funding. In particular, the paper ad vocates pursuing procedural justice as the basis for vertical equity where the focus is on the fairness of how things are done rather than on the dist ribution of outcomes per se (i.e. distributive justice). Particular attenti on is paid to how the principle of vertical equity might be handled at a pr actical level. Details of the approach used in a number of Australian indig enous communities are discussed. It is concluded that there are strong argu ments for pursuing procedural justice under vertical equity particularly wh en there are cultural differences in the ways health is defined and when th ere is importance attached to indigenous involvement in the health care dec ision making process.