 Assuring equitable access in the ways defined by the market approach leaves extensive room for all sorts of departures from equitable access as defined by the use-per-need approach. Surely, there may be variations in the amenities that accompany healthcare services, if that is how we want to look at (some) process variables such as waiting time. Equal quality in these dimensions is surely not required, any more than everyone prefers equal quality in, say, automobiles. Similarly, use-per-need rates may vary with suspect variables like income or race and yet not indicate any inequity of access, contrary to the use-per-need formulation. Rather, the unequal distribution of health care in quantity and quality can be viewed merely as the expression of different preference curves, just as food budgets might vary among a welfare recipient, a factory worker, and a wealthy industrialist. If we take the underlying income distribution to be morally acceptable, its expression in terms of utilization of health services need indicate no inequity.