This article is meant to be a contribution to the debate on growth and welfare. Its argument is based on results of a Grounded Theory study about the German healthcare system, which suggests that the core of the healthcare system can be expressed by two abstract basic ideas that are contradictory and yet dependent on each other. The implications of the results, both for future research on the healthcare system and for the debate on growth and welfare, are discussed. As a final suggestion, "sustainability" is proposed as a concept that could potentially resolve the debate..