Before Romneycare and Obamacare they were paying for bottom run care via their taxes. 

That is why Romney approved Romneycare in Mass., less cost, more uniform coverage In Ontario OHIP has a head tax on employers, while BC MSP had Employer Group Premiums. Left Pocket / Right pocket, Income Tax versus Taxable Benefit versus Head Count based tax on Workers. Quicken categorizes EI and CPP as Taxes. That classification could also extend to the Employer paid portion of EI, CPP, and to Employer paid OHIP or MSP Premiums.