Addressing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations raises operational and ethical issues for the United Nations for High Commissioner for Refugees (UNHCR). Priorities of service delivery, the allocation choices, and the processes by which these choices are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. This discussion document explores key questions of cost and equity as they arise in the context of providing health services to a number of refugee and other populations of concern to UNHCR including those from Iraq. Interviews were conducted with a number of informed and experienced humanitarian practitioners at field, country, and headquarter levels. These interviews helped frame major operational questions that need to be addressed including the status of health care delivery as a relative priority for UNHCR, allocations of resources for health between and within different populations, and strategies for transition and exit.