There's a big difference between having a co-pay plan with an employer and having to put money out of one's own pocket for medical expenses.
Not many people really understand the differences between a co-pay situation and a no pay situation. The co-pay is an arrangement with an employer to pick up part of the doctor's bill after a visit. This is actually a "benefit", not health insurance, although many people think it is health insurance. In any other circumstances, meaning not having a co-pay arrangement through an employer, the person will be paying the doctor's office fees themselves.