This paper presents a way of planning and allocating health-care resources in Ontario, based on population health needs. It is argued that this approach is consistent not only with the principles of the Canada Health Act but also with the vision of health for Ontario. The paper reviews various direct and indirect indicators of need for health care, concluding that our present state of knowledge allows use of the SMR (indicating premature mortality) and for the application of a population needs-based approach which is itself uncontaminated by existing service availabilities and distributions and hence avoids perpetuating any inequalities.