Who Really Pays for Health Care?

Abstract

HEN 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’s Health Insurance Program (SCHIP), and other programs. However,thisisincorrect.Employersdonotbearthecost 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. Failuretounderstandthatindividualsandhouseholdsactually 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.

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