Equity,health, and health care

Equity goals, such as equal treatment for equal need or equality of access, commonly take pride of place among the aims of health policy. But do these conceptions, or others derived from more fundamental philosophical systems such as those of the utilitarians or John Rawls, successfully capture the way in which the term equity is generally used? If not, is it possible to find some interpretation that can command a greater consensus? This paper answers no to the first question and yes to the second. It is argued that the standard conceptions of equity ignore the processes by which health states are determined and hence the extent to which they arise from factors beyond individual control. An alternative conception is proposed that directly incorporates these considerations.