An “invest to save” approach to health

Wrigley makes a compelling ethical and moral case for a universal health service, free at the point of use. 1 Goodman eloquently sets out an important arm of the financial case-introducing top-up requires an additional administrative cost. 2 Given the complexity of healthcare provision, this will introduce inefficiency, which has already been seen in the UK in the context of social care. The Marmot review argues for the investment in children through provision of good quality housing, meaningful access to education, and elimination of poverty to improve long term health outcomes. 4 These provisions are unequally distributed and have become progressively more so under austerity.