"What do we owe each other?" Variously grounded postulates and theories of social justice try to answer this question with regard to health. Equality of opportunity is widely acclaimed and in Germany also anchored in social security laws. From the perspective of equal opportunity, the author examines the state of affairs and the perspectives of equity in health. Although the deficiencies with regard to access and quality of health care are significant, but relatively moderate, they present serious threats to equity and fairness for the future. Regarding non-medical primary prevention, the reduction of inequality in health has barely begun. The largest obstacles to equity in health are to be found in the distribution and dynamics of opportunities for education, work and income. One of the tasks of public health professionals is to place the health consequences of existing policies on the political agenda.