‘Paying back’ is an action, not a noun, and so can’t have a need.
Who is it that needs paying back? Oh, we do? Huh, funny that, almost looks like someone is standing there with a bullhorn spreading nonsense and looking for a handout… or else they’re gonna use their bullhorn to accuse everyone else of looking for a handout.
Healthcare for profit is antisocial.
Demand it all you like.