Imagine a retiree in the United States having to pay an average of $98.70 for insulin, while a retiree in Canada receives the same medicine free of charge. Despite both having worked hard before retirement, they face totally different realities after retiring (Schneider et al. 573). With the development of advanced medicines and medical devices, about 14% of the global population pays out-of-pocket medical-related bills that exceed 10% of their household budget (World Health Organization).
Many have and continue to argue that free healthcare should be provided to everyone as a matter of fairness. However, this essay will argue that providing free healthcare to all individuals is not only impractical, but also unsustainable. Limited funding is our unavoidable reality, and by providing free healthcare, there will be fewer financial incentives for pharmaceutical companies, potentially discouraging research and development. To ensure equitable access to healthcare resources and maximize economic fairness, government support should prioritize disadvantaged groups over universal free access ("Economic Fairness”).
Financial Feasibility and Resource Scarcity
Financial feasibility and scarcity of resources are the primary concerns of the government if it were to provide free healthcare universally. In the United Kingdom, the continuity of healthcare development is a pressing issue. Deputy George Oswald, a previous member of the Health and Social Care (HSC) committee, emphasized that “the current system was ‘unsustainable’ without a funding increase” ("Guernsey Healthcare Funding Unsustainable”), highlighting the budget constraints for the government. They further reported that the issue was reconfirmed by the new president of the HSC Committee, who claimed that the future of healthcare funding remains unknown given the financial deficit. In 2024, the total expenditure, combining both governmental and non-governmental spending, on healthcare was £317 billion, which vastly exceeded the total government income of around £1,136 billion in the same year (UK Health Accounts team; Keep). Fairness aside, we can see from the UK’s finances, the impracticality of providing free healthcare to all when fiscal limitations exist.
The United Kingdom is not the sole case. New research from the World Health Organization indicates that many governments’ funding of healthcare has become insufficient to achieve what is needed for the human rights obligation (“New Data Exposes Global Healthcare Funding Inequalities”). With insufficient and unstable funding, it remains highly infeasible for any government to maintain a healthcare system that meets everyone’s needs, let alone ensure equal quality of care for free.
A better approach would be to transition government assistance into a targeted system, rather than indiscriminately providing free healthcare. Singapore has illustrated this well, as they are known for their sustainable and adequate medical services, while only spending about 4-5% GDP per capita on the healthcare sector (Lim 103). Additionally, Singapore also maintains financial sustainability by executing three themes: strict financial discipline, redistribution of funds and targeted subsidies, and efficiency through market mechanisms (Lim 104). Such a targeted healthcare system avoids large deficits for the government while reducing the economic burden of the poor. Overall, the economic burden and limited resources make it an unsustainable model of providing healthcare for free indiscriminately.
Innovative Decline
A completely free healthcare system can also bring adverse effects to the research and development sector within biopharma industries. New medical innovations are expensive, and their costs only continue to surge. A 2023 Deloitte report has shown that the average cost for the top 20 global biopharma to develop a new medicine increased 15% from $298 million to about $2.3 billion (Philippidis). While the investment may seem huge, it is important to note the vast profit margins. Six of the top 20 pharmaceutical giants had a double-digit increase in revenue in 2024, with others market competitors also reaping considerable profits (Dunleavy). Such profits help to ensure the willingness of companies to keep investing in research and development of new medicines and medical technology.
By stripping the biopharma industries of research grants and finances due to the redistribution of government funding to satisfy healthcare for all, these industries will not have any incentive to keep production going, much less continue the research and development. This would lead to greater disasters with devastating global impacts, as patients would not receive the medical resources needed.
Supporting Disadvantaged Groups
To ensure equitable healthcare services, disadvantaged groups need to be prioritized when distributing resources, instead of offering them to everyone for free. In addition to alleviating fiscal pressures, prioritizing disadvantaged groups can effectively reduce negative social externalities. By truly aiming to support its citizens, the government will focus more on marginalized groups, who, according to the United Nations Economic and Social Commissions for Western Asia, “experience a higher risk of poverty…[especially] elderly people and children” (“Disadvantaged Groups”). By precisely targeting disadvantaged groups, the government can assist those most in need, instead of spending funds on people who can afford medical costs.
Additionally, prioritizing vulnerable groups poses additional societal benefits (Ansari). For example, by vaccinating more people, a greater number of people would be able to protect themselves and reduce the risks of spreading illness in the community. Providing additional aid to those who cannot afford essential medical services ensures access to basic healthcare for low-income populations and consequently relieves the financial burden on medical costs overall. Therefore, a more equitable public health system is achieved by providing necessary support to the most vulnerable groups, ensuring they have fair access to healthcare resources. This is crucial, as indiscriminate distribution of resources could lead to their needs being overlooked because of existing structural barriers they face are not tackled.
Equitable, Not Free
In conclusion, the idea of free healthcare for all is not a fair one. Mostly due to its impracticality, but also because it would bring greater detriments to society. Rather than offering free healthcare universally, targeting and assisting disadvantaged groups would be a better option. Health equity, a crucial aspect of social equity as a whole, should be emphasized and addressed more strategically to prevent good intentions from leading to undesirable outcomes.
Works Cited
Ansari, Saddique. “External Benefit.” Economics Online, 6 Nov. 2021, www.economicsonline.co.uk/definitions/external_benefit.html. Accessed 10 Sept. 2025.
BBC News. “Guernsey Healthcare Funding Unsustainable, New President Says.” BBC News, 14 July 2025, www.bbc.com/news/articles/cgeqp19y7xno. Accessed 10 Sept. 2025.
“Disadvantaged Groups.” United Nations Economic and Social Commission for Western Asia, www.unescwa.org/sd-glossary/disadvantaged-groups. Accessed 10 Sept. 2025.
Dunleavy, Kevin. “The Top 20 Pharma Companies by 2024 Revenue.” Fierce Pharma, 21 Apr. 2025, www.fiercepharma.com/special-reports/top-20-pharma-companies-2024-revenue. Accessed 13 Sept. 2025.
Fiveable. “Economic Fairness – AP US Government.” Edited by Becky Bahr, Fiveable, 2024, fiveable.me/key-terms/ap-gov/economic-fairness. Accessed 13 Sept. 2025.
Keep, Matthew. “Tax Statistics: An Overview.” UK Parliament, 19 Aug. 2025, commonslibrary.parliament.uk/research-briefings/cbp-8513/. Accessed 13 Sept. 2025.
Lim, Jeremy. “Sustainable Health Care Financing: The Singapore Experience.” Global Policy, vol. 8, no. S2, Mar. 2017, pp. 103–09. Wiley Online Library, doi:10.1111/1758-5899.12247. Accessed 10 Sept. 2025.
“New Data Exposes Global Healthcare Funding Inequalities.” Human Rights Watch, 14 May 2025, www.hrw.org/news/2025/04/10/new-data-exposes-global-healthcare-funding-inequalities. Accessed 10 Sept. 2025.
Philippidis, Alex. “The Unbearable Cost of Drug Development: Deloitte Report Shows 15% Jump in R&D to $2.3 Billion.” GEN: Genetic Engineering and Biotechnology News, 26 Dec. 2023, www.genengnews.com/gen-edge/the-unbearable-cost-of-drug-development-deloitte-report-shows-15-jump-in-rd-to-2-3-billion. Accessed 10 Sept. 2025.
Schneider, Tyler, et al. “Comparisons of Insulin Spending and Price Between Canada and the United States.” Mayo Clinic Proceedings, vol. 97, no. 3, Feb. 2022, pp. 573–78. Elsevier, doi:10.1016/j.mayocp.2021.11.028. Accessed 12 Sept. 2025.
UK Health Accounts Team. “Healthcare Expenditure, UK Health Accounts: 2023 and 2024.” Office for National Statistics, 30 Apr. 2025, www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/bulletins/ukhealthaccounts/2023and2024. Accessed 13 Sept. 2025.
World Health Organization. “Universal Health Coverage (UHC).” World Health Organization, 26 Mar. 2025, www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc). Accessed 13 Sept. 2025.