HC Statistics

Who pays for health care? Who uses it?

Ultimately, individuals and households pay for health care. Whether payments are made directly to providers, via taxes or through commercial insurance, households are the sole source of health care financing. Further, all treatments are ultimately provided on behalf of individuals and households. A key question, however, is which types of individuals pay more for health care and who uses most health care dollars?

To answer this question, Carmen et al. (2020) create a synthetic cohort model using demographics, family structure, and income from SIPP, health care expenditure information from MEPS, and employer insurance information from EHBS. ACS data was used to model information for institutionalized individuals.

The authors unsurprisingly that high income people pay for for health care but receive less. Older individuals pay less for health care but receive more. Despite it’s reputation as being non-egalitarian, the US health care system is fairly progressive.


  • Carman KG, Liu J, White C. Accounting for the burden and redistribution of health care costs: Who uses care and who pays for it. Health Services Research. 2020 Apr.

1 Comment

  1. Dr. Jason, every American deserves affordable, comprehensive coverage, regardless of their income, health status, or pre-existing conditions. The reality is however far from it, as we see how the weakness of the system has been exposed in the current Covid-19 crisis. People have to visit doctors to get checked if they have Covid-19 symptoms, yet many Americans may avoid medical care, even for serious conditions, because of the costs.

Leave a Reply

Your email address will not be published. Required fields are marked *