You always pay out of your pocket.

The concept that you make (bad bad) companies pay out of their (outrageous) profit is a delusion.

Companies just take part of your salary and with that they pay medical cost.

I actually prefer paying it myself and having this thing called "free market" or competence work for me.

But in places like the US the system is extremely corrupt and designed to make it impossible for the free market to exist. This is inherited by the political system making mandatory for business to handle that instead of individuals.

In other countries you have things like mutuality organizations of people to provide healthcare, much much better and cheaper that what I see in the US.