75 Romanian Journal of Bioethics, Vol. 10, No. 2, April - June 2012 EDITORIAL Unfair inequalities Bogdan Olaru* The draft of the Health Act concerning the Romanian health care system (November 2011) understands health promotion as having two tasks: an improved picture of the population’s overall health, and a reduction of health inequity. In this respect, the new Act is hardly different from the Act on the Health Reform of 2006. The Government Strategy of rationalizing the health care facilities (HG 303/2011) is built on the principles of equity, quality, responsibility and on the patient-centred medical intervention principle.. The Strategy defines equity as a principle aiming at correcting health inequalities. A health care system is fair if it aims to reduce those gaps in the population's health caused by socioeconomic factors, environment and life style, education and the ability to access health care services etc. The Romanian health care system should aim at two effects: to improve the general health of the population, on the one hand, and to reduce the differences in health between various categories of the population, on the other. The evaluation of the first aim is simple. We can agree on an improvement in the population's health if we notice a significant improvement of some well-known health indicators, such as the incidence and the prevalence of tuberculosis, cancer, diabetes, etc. It is more difficult to assess the progress related to the second aim. First off, we need to answer the question: What inequalities are unfair? What differences in the health state are caused by factors that exceed the individual power to control and correct them and, at the same time, whether they can be controlled and corrected through coordinate and collective intervention? A few considerations on some of these inequalities may give us a better understanding of the significance of these questions, even if the following is not intended to be a final answer in any way. Let us consider the following example: The number of deaths and injuries caused by car or other vehicles in Germany is relatively stable: about 500 persons per 100,000 inhabitants each year (Source: WHO/Europe, HFA-DB). There is a slightly decreasing trend between 2000 and 2009, which could be reasonably explained by some improvement in traffic conditions and emergency aid. The figures are still really high (around half a million casualties in 2000 as a result of car accidents). In the same period of time, this indicator has constantly increased in Romania: between 2000 and 2009 there was a fourfold increase in the number of victims of road accidents. The differences between each year and the year before in Romania contrast with the relative * “Gh. Zane” Institute of Economic and Social Research, Iasi, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania, e-mail: bogdan.olaru@phenomenology.ro