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The first part of this text (points I to IV) demonstrates that the successes and the problems, or malfunctions, of health care systems largely contribute to construct today’s ethical questions and make the concept of a collective ethic in health care a difficult one to achieve. On the basis of this observation, the second part of the text (points V to VIII) pleads for a global concept of the ethic of access to health care, one that could truly respond to today’s challenges in this domain. This plea itself is based on critical analyses: of different ethical justifications of the equality of access to health care and of ideas about limits and rationing. It concludes with a call for a different radionalisation of health care systems, for the development of a contextual ethic – particularly in the hospital environment – and more democracy in sanitary affairs.