as people without public health care coverage have to finance their health care services through private insurance or outofpocket payments they are especially sensitive to a drop in personal income this is especially true for low income people who may forego or postpone health care services because too expensive devaux and de looper comparing equity of access to health care services in oecd countries find that in countries with higher public expenditure the frequency of doctor visits are more equally distributed among people of different incomes also devaux and de looper show that inequality in specialist dental visit is increasing in the share of outpocket payment as percentage of total expenditure on specialist dental care