 Some philosophers have taken these implications as a reductio ad absurdum of luck egalitarianism (Anderson 1999), and they would no doubt be rejected by many writers on health care, who have questioned the moral and policy relevance of individual responsibility (Cavallero 2011; Feiring 2008; Galvin 2002; Wikler 1987). The greater concern for disability scholars may be with the conflation of disadvantages resulting from unchosen impairments with disadvantages resulting from unchosen social conditions under the one heading of “bad brute luck”. Luck egalitarianism does not, as such, provide any principled rationale for distinguishing between equally severe setbacks to the well-being of people with disabilities that result from the “bad luck” of being born in a society with disability discrimination and the “bad luck” of being born with an intrinsically disadvantageous set of physical abilities. Both are equally unchosen from the individual’s standpoint, and it is individual responsibility, rather than some combination of individual and collective responsibility, that determines whether a given disadvantage generates a valid justice complaint. This is not to deny that luck egalitarianism can be supplemented to account for the intuition that the “bad luck” of being born in a disabling environment (Fine and Asch 1988) differs morally from less socially mediated forms of bad luck, as we will see in our discussion of the capabilities approach.