Obviously the money comes from the taxpayer. Because it's a service everyone needs. It's also a service that everyone needs everyone else to have too.
But if the average citizen only generates $400 worth of actual product/service per year, it will be hard to pay for that $4000 per year medical cost. What is the actual output of Americans etc? Nobody knows, because your dollar/pound measuring stick, is rubber. Also the balance sheet is completely corrupted, so that the debits and credits are not credible. This is a problem with a non-tribal society. If you are in my tribe, I am obligated to take care of you (and beat you if you a lazy). In a nation, there is no tribal obligation. And of course with class, even if we are in the same tribe, the tribal elders think they are the only one's who deserve support.
And no, money gets cycled thru the taxpayer, but they aren't the one's who create it. The government creates it (as is necessary when we went to a monetary economy). The Pharaoh didn't need money, he was a god-man, and could get you to give him the agricultural surplus, and then employ that food to feed the labor surplus, to move big stones around. Nothing has changed in 4500 years ... except money makes it much easier to run an economy. The amount of money you have, or make per year, is a measure of your value. No money, no value. Hence poor people deserve poverty.