Prominent among the principles put forward by Professor Bernard Williams in ‘The Idea of Equality’ were that for every difference in the way men are treated a relevant reason should be given and the proper ground of the distribution of medical care is ill health. Prominent among his conclusions was that we are confronted with an irrational state of affairs where wealth functions as a necessary condition for receiving medical care. In ‘The Idea of Equality Reconsidered’ Philosophy (January 1973) 85–90), I argued that, on his principles alone, this conclusion though correct was one-sided.