Background: Private health insurance (PHI) is a relevant financing source in many health care systems, including the Austrian one where more than a third of the population possess such an insurance. The effect of PHI on redistribution preferences in health care has been an understudied phenomenon. This article examines such a relationship. Further the mediating effect of fairness attitudes within said relationship is analysed.Methods: The data for this study come from the Austrian Corona Panel Project (ACPP). OLS regression models are employed to elicit the links between the variables.Results: In this article evidence for considerable self-interest in support for redistribution in health care with matching fairness attitudes is found. Additionally, social redistribution preferences for benefits and taxation, political party preferences and pandemic risk perception play a role. Conclusion: Health policy makers should carefully consider these relationships when adapting the public health care system to challenges, such as increased financing pressure or a pandemic. This could be done by incorporating vulnerable groups and public preferences at large in an open debate about the design of the health care system, its financing and its consequences for redistribution.