<p>A central tenet of health equity is that access to healthcare should be responsive to need rather than patients’ socioeconomic status. The idea that ability to pay can enable some people to access faster, better, or more healthcare strikes many egalitarians as clearly objectionable. This paper argues that this view is more complicated than may initially appear. While there are egalitarian reasons to oppose private healthcare, these are often less decisive than they may initially appear and prohibiting private healthcare on egalitarian grounds is likely to run afoul of egalitarianism’s liberal commitments. There are several important theoretical hurdles to pass through for a successful egalitarian argument against private healthcare, which this paper aims to highlight.</p>