Now, consider a policy change brought about
by some health egalitarians, which gives priority to
reducing health inequality. This prevents rich A
from buying a cure that poor B cannot buy. Poor
B’s life is unaffected, but now rich A too lives with
that painful ailment, spending his money instead
on, say, having consoling trips on an expensive
yacht on esoteric seas. The policy change does, in
fact, reduce the inequality of health, but can it be
said that it has advanced health equity? To see
clearly the question that is being asked, note that it
is not being asked whether this is a better situation
overall (it would be hard to argue that it is so), nor
am I asking whether it is, everything considered, a
just arrangement (which, again, it is not – it would
seem to be a Pareto worsening change, given A’s
desire to use his money to buy health, rather than
a yacht). I am asking, specifically, is there more
health equity here than in the former case?