The view that a person deemed responsible for her own disease or injury should be deprived of healthcare resources has obtained considerable support from a philosophical viewpoint known as “luck egalitarianism.” Three basic underlying assumptions are identified, each of which is necessary for this view to be at all credible: that it can be determined whether a person caused her own disease or injury, that blame responsibility can justifiably be assigned to her if she did so, and that this is a sufficient moral reason for withholding treatment that would otherwise have been available to her. This chapter shows that each of these assumptions is untenable. Analysis also makes it clear that the “luck egalitarian” proposals would in practice only affect poor people who would then be largely punished for behaviors into which they have been deceived by the marketing tricks of the tobacco, alcohol, and soft drink industries. Such a policy does not answer to any reasonable definition of egalitarianism. A more suitable term for this standpoint is “luck anti-egalitarianism.”.