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The Myth of "Shared Responsibility"

Ezekiel J. Emanuel, MD, PhD; Victor R. Fuchs, PhD

JAMA. 2008;299(9):1057-1059.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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's Health 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.

The Myth of Shared Responsibility

Many sources contribute to the misperception that employers and government bear . . . [Full Text of this Article]

Author Affiliations: Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, Maryland (Dr Emanuel); Department of Economics, Stanford University, Stanford, California (Dr Fuchs).

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