Introduction: One criterion to measure the achievement of a government's performance is stability and decreasing the misery index that is the sum of inflation and unemployment. Therefore, this study aims to investigate the impact of misery index on patients' out-of-pocket-payments in the Iranian healthcare system. Methods: This paper has used time-series data from 2000 to 2016 and it used three methods to examine the relationship between variables. First, the Dickey-Fuller test was used to evaluate the stationary of variables. Second, the Toda-Yamamoto causality test was used to test causality between variables. Third, Auto-Regressive Distributed Lags (ARDL) was used to test the long-run relationship. Analyzing data was conducted by Eviews 9 software.Results: The results showed that there was a bi-directional causal relationship between the misery index and the out-of-pocket-payments of patients in the health system. Also, increasing 1 unit of misery index increased 1.33 units of out-of-pocket-payments. The correction error coefficient was -0.435 that meant this amount was adjusted per period. In other words, it lasted more than 2 years and less than 3 years that the Nonequilibrium points converge to their long-run points of the relationship.Conclusion: Implementing appropriate policies in order to reduce unemployment and inflation rate can decline the out-of-pocket-payments in the Iranian healthcare system.