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Income inequality is on the rise, and everyone, from President Obama and Pope Francis to Prince Charles and Standard & Poor’s, is talking about it. But these conversations about what are arguably the most significant changes in the distribution of incomes and earnings since the 1940s are leading to very different views on how public policy should respond. This is as true in Canada as it is in almost all of the other rich countries where inequality has risen. In this paper, I tell two stories about inequality—one from the perspective of those who feel it is not a problem worth the worry, and the other from the perspective of those who see it as the defining challenge of our time—to clarify the issues facing Canadians and what public policy should do about them. [ABSTRACT FROM AUTHOR]

Residents of Ontario aged 65 years and older are covered by a provincially funded prescription drug program. The aim of this paper is to assess the extent of inequity in prescription drug use for people eligible for Ontario Drug Benefit coverage, and to explore the different possible explanations for inequities. The analyses draw on the Canadian Community Health Survey from 2005, which is linked to pharmacy and Ontario Health Insurance Plan claims data. We model the number of therapeutically different prescription drugs and the total expenditures on medications on a set of health, demographic, and socioeconomic indicators, and we calculate the concentration index of income-related inequality in medicine use. The results show that low-income individuals who have enrolled in the reduced cost-sharing program on average use more medications than those with higher income, even after adjusting for a comprehensive set of health and demographic variables. While Ontario's public drug program appears to have ensured access to medications for low-income seniors, the results of this study raise concerns about the potential inappropriateness of medication use and point to a gap in drug policy in Ontario. [ABSTRACT FROM AUTHOR]