 Arguably, the goal of universal access to health care, as embodied in health systems in nearly all developed countries, is to secure equal or at least equitable access to needed care. How can we tell whether or not access to care is equal? What should we count as equitable access, if this involves departures from equal access? We might hope that it is relatively unproblematic to determine when access to care is equal, as it is, for example, with income, and that equitable access would then consist of allowable or justifiable inequalities in access. As we shall see in this Section, giving an account of equal access, let alone equitable access, is not so easy.