Why do citizens in Uganda choose nonstate health-care providers instead of free public health services? How does experience of the nonstate provision of health care strengthen or undermine citizen capacity to seek accountability? Based on original empirical data from Uganda, respondents rate private health-care services as being of much better quality than those found in the public sector. Study findings reveal little or no demand for accountability for better health services. This is associated not only with the rise of nonstate actors, but also with other factors, among which are the dictatorial tendencies of the current regime in power, which has prevented a potential coalition between urban elite private users and rural poor public users.