This research paper examines the equity in the delivery and financing of health care for both the public and the private sectors in South Africa. Using nationally representative datasets and standard methodologies for assessing progressivity in health care financing and benefit incidence, the authors report an overall progressive financing system but a pro-rich distribution of health care benefits. The progressive financing system is driven mainly by progressive private medical schemes that cover a small portion of the population, mainly the rich. The distribution of health care benefits is pro-rich ; richer groups receive a far greater share of service benefits within both public and private sectors despite having a relatively lower share of the ill-health burden.