Background: Healthcare systems’ dependency on resources threatens their resilience to future crises. Our aim was to determine the evolution of the resource footprints, dependency and efficiency of healthcare systems and to determine the relationship between this evolution and their healthcare access and quality (HAQ) index. Methods: We carried out an input-output analysis of 49 healthcare systems from 1995 to 2015. Findings: Healthcare systems’ footprint increased over the last two decades, reaching 7% of global non-metallic minerals footprint, 4% of global metal ores footprint and 5% of global fossil fuels footprint in 2013. This increase was mostly due to China, rising from 7% of the non-metallic minerals footprint in 1995 to 45% in 2013. 80% of the healthcare systems studied were dependent at more than 50% on fossil fuel imports. The energy footprint per capita increased exponentially with the HAQ index. Increasing the minimum world HAQ index to 100 would imply an increase by 744% of healthcare’s energy footprint. Healthcare systems have not become more efficient between 2002 and 2015. We measured over 1000 other impacts, available with this paper. Interpretation: By increasing their HAQ, healthcare systems become exponentially dependent on resources. High-income countries will have to weigh up between reducing their healthcare system’s resource consumption or shifting the efforts on other sectors, health being considered an incompressible need. This second option could make healthcare systems even more vulnerable to resource crises. We call for the creation of a “HAQE” (healthcare access, quality, and efficiency) index that would add resource efficiency to access and quality when ranking healthcare systems.