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在许多发展中国家，人们对卫生保健费用的支付能力，或者说对卫生保健费用的承受能力，是一个十分重要的政策性问题，以往的研究和政策上的争论集中在各种基本服务的支付意愿上，而且倾向于假定两者同义。史蒂文·拉塞尔在牛津大学出版社１９９６年出版的《卫生政策与规划》１１（３）上撰文，对这种假定表示了疑问。他认为支付意愿并不反映支付能力，并提出了依据基本需求和应付方案的机会成本对支付能力进行评估的方法。而且将普通家庭的应付方案进行归纳。他还建议开展深入的纵向家庭研究，准确地评价支付能力，以便在制定政策时充分考虑到人们的承受能力。
In many developing countries, people’s ability to pay for health care costs, or the affordability of health care costs, is a very important policy issue. Past research and policy debates have focused on the payment of various basic services. Willing, but tend to assume that the two are synonymous. Steven Russell wrote an article in Health Policy and Planning 11 (3), published by Oxford University Press in 1996, questioning this assumption. He believes that the willingness to pay does not reflect the ability to pay, and proposes a method of assessing the ability to pay based on the basic needs and the opportunity cost of the solution. And general family coping schemes are summarized. He also suggested that an in-depth longitudinal family study be conducted to accurately assess the ability to pay in order to take full account of people’s ability to bear when formulating policies.