This paper argues that equal per-capita health care premia offer no systematic advantage as an instrument of financing the welfare state. Either will simultaneous changes in the tax system be necessary to compensate their redistributive effects, in which case all efficiency gains derived from a switch to income-independent health care premia will also be lost. Alternatively, if one wants to change the progressiveness of the overall tax and social security system in Germany, this can equivalently be done through a reform of the tax system. This is shown using simplified formulae for the German system of income taxation and health care finance. Instead, it is argued that the advantage of equal per-capita premia lies in its potential to reduce health care expenditures, by way of facilitating the use of co-payment schemes which reduce the moral hazard problem in health care markets.