The rapid pro­gress in medi­cal tech­no­lo­gy makes it unavo­ida­ble to rati­on health care. In the dis­cus­sion how to rati­on many peo­p­le cla­im that prin­ci­ples of jus­ti­ce in dis­tri­bu­ting scar­ce resour­ces should be appli­ed. In this paper we argue that medi­cal resour­ces are not scar­ce as such but scar­ci­ty is a neces­sa­ry by-pro­duct of coll­ec­ti­ve finan­cing arran­ge­ments such as social health insu­rance. So the right ques­ti­on to ask is the deter­mi­na­ti­on of the bene­fit packa­ge of such an insti­tu­ti­on. Hart­mut Kli­emt is curr­ent­ly invol­ved in a com­men­da­ble inter­di­sci­pli­na­ry rese­arch pro­ject in which prin­ci­ples of prio­ri­tiza­ti­on‘ of medi­cal care are stu­di­ed. This con­tri­bu­ti­on adds a spe­ci­fic per­spec­ti­ve to this endea­vour: we ask how the goal of dis­tri­bu­ti­ve jus­ti­ce can be inter­pre­ted in this con­text and compa­re dif­fe­rent approa­ches to imple­men­ting just‘ allo­ca­ti­on mechanisms.