ABSTRACT
Many people would find systematic differences between racial groups in access to health care to be ethically and politically intolerable, while they might be willing to accept equally large differences between random individuals. In regard to the domain of inequality, the question is not which people have unequal access but which aspects of health care are differentially accessible. At issue may be access to health services or insurance coverage, entry into health careers, or participation in medical decision-making. Even though governments of all kinds may provide health care to gain legitimacy, a democratic government might be loath to become liable for all health care services precisely because doing so would unleash demands and provoke conflicts that could prove hard to control. Many people who generally favor the liberal democratic preference for decentralized market mechanisms switch sides when it comes to health care—one instance where social democracy seems to be more fiscally responsible as well as more equitable.
