Health care in the United States: who pays?

Abstract

The lopsided distribution of wealth in the United States is perpetuated by the regressive taxation system and the payment of public subsidies to large corporations. These factors operate in important ways in the health system. Health care finances—whether out-of-pocket payments, insurance premiums, or social security—burden the poor far more heavily than the rich. Even the more equitable federal income tax spares wealthy individuals and corporations. National health insurance will not rectify the unjust nature of health care financing since it relies chiefly on regressive payments and insures profits for health-related corporations. Because poor health is closely linked to poverty, the redistribution of wealth is a fundamental tenet of sensible health policy.