Who pays for your health care?

At the beginning of the workshops I teach, I always begin with a brief review of this fact:  that American Health Care is not about health and it’s not about care;  it’s about sickness and it’s about money.  I then go on to explain the three-cornered payment system:  we patients (or our employers) pay the insurance company, the insurance company pays the provider.  And sometimes, of course, we have co-pays.

One gentleman said he never has to pay for healthcare.  He gets his for free.

Free?  uh-huh — sure.

I asked him if he works for a living.  No, he said he is retired.  So I asked him if his employer paid for his medical care and he said yes — and that’s why he gets his healthcare now for free.

I waited until after the workshop was over, but I felt compelled to explain this truism to him.  For all those years he worked, his employer was paying premiums for health insurance on his behalf.  That doesn’t mean it didn’t cost him anything — what it means is that because the employer had to pay those premiums, that was money that didn’t get paid to the man!  In addition, he had money taken out of his check for medicare and social security — and that’s why the government pays for part of his healthcare now.  Even today he’s paying into the system with his retirement checks.

He had never thought about it that way.

Here’s the thing.  If we remember that WE are paying for our healthcare, then it’s easier for us to think as consumers, and not just as patients.  If you pay your mechanic for fixing your car, it comes directly out of your pocket, and you have expectations for the outcomes, and the service provided. 

Doctors, hospitals, test centers, urgent care centers and other providers are our body mechanics.  We are paying them out of our pockets, too — just that sometimes it’s not quite so direct. 

Being a sharp patient means we are being good consumers, too.

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