ABSTRACT
Distribution according to need is often associated with the principle of equality. This chapter considers the argument that the needs principle is equivalent to the equality principle, and offers a formulation of the former which can be used in social policy contexts. All members of the community might need extra police protection in the sense that they would benefit from the lower level of risk that this would bring. The plausibility of the extensional equivalence view seems to derive from an implicit assumption that the appropriate end-state from which to view the claims of need is equality. In hospital management and health programmes the apparent infinity of needs has led to dramatic calls to ‘ration’ health care. The principle of a medical risk-pool assumes that an increase in mortality or morbidity risks is an individual cost which ought, if possible, to be compensated. However, although in general true, the assumption is not always valid.
