There are seventy medical care providers within walking distance of every household in Delhi. However, inequalities in health outcomes persist among the rich and poor, which might reflect differences in the quality of available care. This paper shows that providers visited by the poor were indeed less knowledgeable than those visited by the rich. There is strong evidence of inequalities in access, with lower competence among privateand public-sector providers in poor neighborhoods, but no evidence of inequalities in choices. Practical policy options include targeted information to patients on provider competence and improving the allocation of public doctors across poor and rich neighborhoods. [Health Affairs 26, no. 3 (2007) I n d i a s p e n d s 6 p e r c e n t o f i ts g r o s s d o m e s t i c p r o d u c t (GDP) on health-three times the amount spent by Indonesia or Philippines and twice the amount spent by China. 1 Surveys show that 60 percent of health spending is for primary care; of this, households contribute more than 80 percent. 2 It is usually assumed that a large proportion of spending devoted to acute illnesses reflects the prevalence of morbidities with high case-fatality ratios (such as tuberculosis) or diseases leading to permanent disability (such as leprosy).The problem of health care is often assumed to be low availability; increasing availability is thought to reduce the delays in seeking care and therefore the cost of treating illnesses. This point of view is not unique to India. The influential 1978 Alma-Ata Declaration, for instance, identified better health outcomes with increased availability of primary care: w 3 3 8 2 7 M a r c h 2 0 0 7 Q u a l i t y V a r i a t i o n s