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Thanks, Joy. Yes, the idea is indeed that it's chance that largely determines whether we fall ill and what intervention we need when we do. Using CEA to allocate scarce public funds means that less well-off people are fine if the intervention they need is on the benefit package, but not otherwise. Introducing randomness into how much someone pays toward the cost of their care would help narrow inequalities in the likelihood of people being able to afford they need. And as I say, it doesn't haven to be completely random: we can adjust someone's odds upwards if the intervention they need is especially cost-effective. A.