Reflecting on Equity in the Healthcare System

The demand for equity haunts public health like an elusive ghost. It continues to be more a matter of broad political-or even ethical-principles than a source of concrete action. This is evident in the health care reforms that have taken place in most industrialized countries. In this essay, Didier Castiel examines the relationship between economics and ethics. He is particularly interested in how the principle of equity formulated by John Rawls is incorporated into economic calculations applied to health care. To illustrate this, he proposes a new model for distributing daily sickness benefits-a model that could serve as a basis for any reform of the health care system.