Need for health care services versus ability to pay

Universal health care systems such as Canada's seek to ensure access to care on the basis of need, rather than income. However, recent research has pointed to the possibility that those with higher incomes and higher levels of education were getting better access to specialized services.

Murray Finkelstein studied data for 2170 Ontario respondents to the 1995 National Population Health Survey who had approved linkage of their survey responses to the administrative databases of the Ontario Health Insurance Plan. He found that the mean per capita expenditure among the upper middle income group was $220 less than the mean per capita expenditure in the lowest income group. Finkelstein also found that health expenditures were related more to self-reported health status than income. Based on these findings, the author concludes that "utilization of physicians' services in Ontario is based on need, rather than income.

Do factors other than need determine utilization of physicians' services in Ontario? - M.M. Finkelstein

Contact: Dr. Murray Finkelstein, Family Medicine Centre, Mount Sinai Hospital, Toronto.

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