 I earlier noted that one objection to the utilization rate approach is that similarity in intergroup use-per-need rates is not even a necessary condition for equitable access (or distribution). One rationale for this claim is the view that health-care services are commodities like any others. On this view, there is nothing so ‘special’ about these services that cannot be accommodated by allowing a market for them to respond to people’s preferences for them. On such a view, equity of access is assured if three main conditions obtain: (1) the commodity must be available at something like “true social cost;” (2) individuals are capable of making rational (informed) decisions about using the system; (3) income distribution must be (approximately) equitable. The second condition requires that information about alternatives—for example, therapies or insurance schemes—is available and that people are competent and informed enough to make use of the information. Some access inequities arise when this condition is not met and these must be addressed by public policy. (We shall see how these conditions affect the philosophical arguments about prudential insurance in the Section 3.)