determinants between different population groups. Health care Health inequalities are in many cases related to access to health care. In industrialized nations, health inequalities are most prevalent in countries that have not implemented a universal health care system, such as the United States. Because of the US health care system is heavily privatized, access to health care is dependent upon one's economic capital; Health care is not a right, it is a commodity that can be purchased through private insurance companies (or that is sometimes provided through an employer). The way health care is organized in the U.S. contributes to health inequalities based on gender, socioeconomic status and race/ethnicity. As Wright and Perry assert, "social status differences in health care are a primary mechanism of health inequalities". In the United States, over 48 million people are without medical care coverage. This means that almost one sixth of the population is without health insurance, mostly people belonging to the lower classes of society. While universal access to health care may not eliminate health inequalities, it has been shown that it greatly reduces them. In this context, privatization gives individuals the 'power' to purchase their own health care (through private health insurance companies), but this leads to social inequality by only allowing people who have economic resources to access health care. Citizens are seen as consumers who have a 'choice' to buy the best health care they can afford; in alignment with neoliberal ideology, this puts the burden on the individual rather than the government or the community. In countries that have a universal health care system, health inequalities have been reduced. In Canada, for example, equity in the availability of health services has been improved dramatically through Medicare. People don't have to worry about how they will pay health care, or rely on emergency rooms for care, since health care is provided for the entire population. However, inequality issues still remain. For example, not everyone has the same level of access to services. Inequalities in health are not, however, only related to access to health care. Even if everyone had the same level of access, inequalities may still remain. This is because health status is a product of more than just how much medical care people have available to them. While Medicare has equalized access to health care by removing the need for direct payments at the time of services, which