Saum Sutaria, M.D.

Some of that is spent in you and I both would contribute to the insurance we procure. And some of that were directly consuming health care by spending money on health care services out of our pockets. But think about it as one fourth or one trillion. Employers put another trillion into the system. So how do they do that? Largely through employer sponsored insurance. So that's the second trillion.

Some of that is spent in you and I both would contribute to the insurance we procure. And some of that were directly consuming health care by spending money on health care services out of our pockets. But think about it as one fourth or one trillion. Employers put another trillion into the system. So how do they do that? Largely through employer sponsored insurance. So that's the second trillion.

So now you've accounted only for half of it. So where's the other half coming from? The other half is coming from government, federal government and state government. These days, a lot of it is federal government. And the federal government contributes in two different ways, direct expenditures, and as we'll get into when we start talking about history,

So now you've accounted only for half of it. So where's the other half coming from? The other half is coming from government, federal government and state government. These days, a lot of it is federal government. And the federal government contributes in two different ways, direct expenditures, and as we'll get into when we start talking about history,

employer-sponsored coverage being the dominant source of coverage is unique to the United States, which is that your employer procures health insurance for employees, which then provides a form of coverage.

employer-sponsored coverage being the dominant source of coverage is unique to the United States, which is that your employer procures health insurance for employees, which then provides a form of coverage.

That's correct. But it's coming through your employer. And most people would recognize that because of their annual enrollment. So they're picking Blue Shield or Aetna or Cigna or United, or if they're in a Medicare plan, they may be looking at Humana or other Blues plans.

That's correct. But it's coming through your employer. And most people would recognize that because of their annual enrollment. So they're picking Blue Shield or Aetna or Cigna or United, or if they're in a Medicare plan, they may be looking at Humana or other Blues plans.

So you've got a fourth that people are spending out of pocket in one form or another. Some of it, of course, to subsidize their ability to buy insurance. A fourth that's coming from employers directly out of their profits. Now think about that trillion dollars for one second. Total U.S. corporate profits are about, interestingly, coincidentally, just south of $4 trillion.

So you've got a fourth that people are spending out of pocket in one form or another. Some of it, of course, to subsidize their ability to buy insurance. A fourth that's coming from employers directly out of their profits. Now think about that trillion dollars for one second. Total U.S. corporate profits are about, interestingly, coincidentally, just south of $4 trillion.

Corporate profits. Okay, post-tax. So the expenditure in healthcare is pretty significant when you think about it that way. Now, off of total revenues, of course, it's a lot lower as a percentage. But if you think about it from the perspective of total corporate profits, that's a big, big number.

Corporate profits. Okay, post-tax. So the expenditure in healthcare is pretty significant when you think about it that way. Now, off of total revenues, of course, it's a lot lower as a percentage. But if you think about it from the perspective of total corporate profits, that's a big, big number.

The US consumer spends, you should think of it this way, for that $1 trillion, if you have a $20 bill, $1 of that is going into direct healthcare expenditure, like 5% of someone's expenditure in an annual average basis. And then you've got the government. The government's spending about $2 trillion. Again, it's direct spend plus there's tax subsidy for employer-sponsored insurance.

The US consumer spends, you should think of it this way, for that $1 trillion, if you have a $20 bill, $1 of that is going into direct healthcare expenditure, like 5% of someone's expenditure in an annual average basis. And then you've got the government. The government's spending about $2 trillion. Again, it's direct spend plus there's tax subsidy for employer-sponsored insurance.

We'll get into that because that's a unique feature. When you talk about 1950s, 1954, the tax benefits for providing employer-sponsored insurance were codified into law.

We'll get into that because that's a unique feature. When you talk about 1950s, 1954, the tax benefits for providing employer-sponsored insurance were codified into law.

And that's the incentive. And that's the incentive that started back in 1954, which is that giving people healthcare coverage through group-purchased insurance by your employer is a pre-tax benefit rather than a post-tax benefit.

And that's the incentive. And that's the incentive that started back in 1954, which is that giving people healthcare coverage through group-purchased insurance by your employer is a pre-tax benefit rather than a post-tax benefit.

So it created an incentive for employer-sponsored insurance to grow and now, of course, ultimately become the dominant form of which people procure insurance today outside of government.

So it created an incentive for employer-sponsored insurance to grow and now, of course, ultimately become the dominant form of which people procure insurance today outside of government.