In 2011, the Government committed to the introduction of Universal Health Insurance (UHI) ‘with equal access to care for all’ by 2016 (Government of Ireland 2011: 2). This chapter explores how proposals to implement a system in which every member of the population would be expected to take out health insurance – and mooted by politicians as a way to end Ireland’s two-tier health system – exhibited particular characteristics of advanced liberal modes of governing.Specifically, drawing on Rose and Miller’s (1992) conceptualisation of the ‘aspirations’ of advanced liberal government – governing at a distance, the management of risk, engendering individuals to take responsibility through choice, and the fragmentation of the social state into multiple communities – this chapter demonstrates how while a political rhetoric may have stressed the significance of UHI as a basis for promoting solidarity and fairness, it is hard to avoid the conclusion that the policy would have represented a further shift towards the marketization of Irish healthcare.