one possible explanation for this is that as nations become richer people place higher value on health and want to spend a larger share of their income on improving their health fogel the income elasticity varies a lot in empirical results and whether health care is a luxury good or a necessity is still an unsettled issue results for the us and canadian provinces as well as nationallevel data for oecd countries confirm that estimates of the size of the income elasticity vary by level of analysis with international income elasticity generally larger than elasticities estimated in national or regional studies di matteo