Paul, you pay a much higher amount indirectly through exorbitant taxes. If you were to sit down and compare what an average middle class person pays in both taxes and health care in the USA, vs taxes and health care in the UK for instance, I can assure you of two things: 1) The US person pays less overall, and 2) the quality of health care is much higher in the US. Where do the worlds wealthy usually travel to for health care when they are really sick?