 Appeals to an “average” insurance package similarly provide no clear basis for deciding whether a set of benefits is truly appropriate to a decent minimum. For one thing, the average may reflect many features of a market that is not working well, capturing much that is wasteful, ineffective, or inappropriate in a system providing care. It may also be the case that an average package omits some crucial features of care, for example, certain mental health services. Indeed, by focusing on services provided within a given system to “average” users, the concept of what we owe people, that is, what counts as equitable treatment, is turned into a completely “interstitial” notion. We are told, “within the confines of this system, equity requires making this package available, since it happens to be available on average” but we are not in a more general way told that the system provides people with what they should get, as a matter of justice. We are, in effect, told that a system that aims to meet certain needs should treat people equitably in addressing those needs, but we are not told that a system that is fair to people should perforce meet certain health needs. Nor are we given a process that might help us decide what to provide as a matter of justice where there may be disagreement about equitable coverage. In short, neither lists nor averages substitute for an appeal to a defensible rationale or to a fair process for determining what should be covered. (We shall consider in Section 3 how the insurance approaches of Dworkin (1994) and Gibbard (1982) address these issues, since each approach is part of an argument to justify the appeal to equal access; the choice model takes equal access for granted and does not make an attempt to justify it, and so we do not discuss it in Section 3.)