Americans without health insurance for any part of 2008 will spend $30 billion of their own money for medical care. Many cannot pay their own expenses and they rack up another $56 billion in medical expenses. Most of that amount - $43 billion - is paid by various state and federal government programs: $18 billion by Medicare and Medicaid, $15 billion by state and local government indigent programs, and $10 billion by the Veterans Administration.

The uninsured that pay out of their pocket for medical care pay more overall and get a lot less care for their money. Someone who is uninsured all year pays 35 percent ($583) out of pocket toward their average annual medical costs of $1,686 per person. In contrast, annual medical costs of the privately insured average $3,915, with $681, or 17 percent, paid out of pocket.