**5. Equity in health care financing**

Equity has been one of the important variables in health care systems, but inequities in health care financing and access are still very pervasive. Ample evidence suggests that the poor have less access to health care and suffer more devasting consequences of morbidity and mortality than the rich. The poor have lower levels of health care utilization than the rich, though they have more health needs and spend more on health care as percentage of their income than the wealthy individuals [17].

In this section, equity is contextualized as equity in access to health insurance, health care, and equity in health care delivery: distribution of health care services, urban-rural dichotomy, and ethnic minority communities. The Nobel Prize winner Amartya Sen [18] argues that health is one of the most important variables of human life and an important constituent of human capability, but the pervasiveness of inequalities in health care access and delivery is more disturbing than any other sectors.

Equity in health means that ideally everyone should have a fair opportunity to invest in their health to attain full health potential without any one being disadvantaged from achieving this potential if it can be avoided [19]. Equity can, thus, be explained as an ethical concept which is grounded in the principles of distributive social justice. Regrettably, different people and different authorities tend to interpret equity in diverse ways. To counterbalance the open interpretation of equity and create an operational concept, Braverman and Gruskin [20] defined equity (in health) as "the absence of socially unjust or unfair health disparities, the absence of systematic disparities in health (or in the major social determinants of health) between social groups who have different levels of underlying social advantage/disadvantage." This definition reminds us that the society is composed by diverse groups of people with different capabilities, sexual orientation, and different wealth gradients with unique needs in various locations. We call for a society where both the haves and the have-nots have equitable health insurance and universal health coverage without discrimination.

Based on the experts' definitions and Rawls' theory of justice, I conceptualize equity in this paper, as fairness in financial contribution (premium payment), fairness in health insurance coverage and access to health care, fairness in health care delivery, and fairness in the determination of benefits package. For example, the premiums of health insurance should be based on individuals or households' ability to pay. The wealthy individuals or households should pay more, according to some progressive principle while poor pay less, and indigents should be covered by safety net insurance.

*Health Insurance for Economically Disadvantaged People in LMICs: What are the Best Options? DOI: http://dx.doi.org/10.5772/intechopen.105679*
