"If you're not paying for it through the health plan, you pay for it in the emergency room"

This quote by David Lehman is referring to the cost of health care. He is recommending that if you do not have health insurance, you will end up spending for treatment in the emergency room. This is due to the fact that emergency rooms are required to deal with all patients regardless of their ability to pay. For that reason, if you do not have health insurance, you will need to pay out of pocket for any medical care you receive in the emergency room. This can be extremely pricey and can lead to financial hardship. Therefore, it is very important to have medical insurance in order to prevent spending for medical care in the emergency clinic.