The ECuity Project, now in its third phase, compares inequality and
inequity in health and health care across countries.
What is equity? The project has explored how equity is defined by
medical and political philosophers, policy makers and academic
researchers. It has developed a set of methodologies to provide
practical tools for the measurement and explanation of inequality and
Equity in health care finance
Countries vary in their financing mixes. Some emphasize taxes,
others emphasize social insurance, others still emphasize private
sources — private insurance and out-of-pocket payments. These sources
vary in their progressivity: income taxes, for example, are often
concentrated amongst the better-off, whilst the poor pay a very large
share of out-of-pocket payment payments. Sources also vary in the degree
to which they achieve horizontal equity: with private sources there is
typically a much larger variation in payments at a given income level.
Equity in health care delivery
Are people in equal need of health care treated the same,
irrespective of how well-off they are? And does the degree to which this
is true vary from country to country? Are the differences related to
features of the health care systems of the countries? Answering these
questions requires measures of equity in health care delivery. In
addition to developing these, the project has also produced comparable
results on equity in health care delivery for several OECD countries.
The project is also analysing inequalities in access conditions — how,
for example, insurance coverage and the liability for out-of-pocket
payments varies across income groups — and the effects of inequalities
in access on utilization.
Inequalities in health
Do the better-off enjoy better health than the poor? Do health
inequalities vary across countries? What causes differences in health
inequalities between countries? Getting answers to these questions
requires measures of health inequality. In addition to developing these,
the project has also produced comparable results on health inequalities
for several countries, and is also analysing the socioeconomic
determinants of health at the individual level.