Freeman Spogli Institute for International Studies Center for Health Policy/Center for Primary Care and Outcomes Research Stanford University


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Who Really Pays for Health Care? The Myth of "Shared Responsibility"

Journal Article

Authors
EJ Emanuel
Victor R. Fuchs - Stanford University

Published by
Journal of the American Medical Association, Vol. 299 no. 9, page(s) 1057-1059
March 5, 2008


When asked who pays for health care in the United States, the usual answer is "employers, government, and individuals." Most Americans believe that employers pay the bulk of workers' premiums and that governments pay for Medicare, Medicaid, the State Children'sHealth Insurance Program (SCHIP), and other programs.

However, this is incorrect. Employers do not bear the cost of employment-based insurance; workers and households pay for health insurance through lower wages and higher prices. Moreover, government has no source of funds other than taxes or borrowing to pay for health care.

Failure to understand that individuals and households actually foot the entire health care bill perpetuates the idea that people can get great health benefits paid for by someone else. It leads to perverse and counterproductive ideas regarding health care reform.