How does payment of donating sperm work , the healthier the patient the more money you receive or the other way around?

No difference: All donors are expected to be "healthy" and free of disease. That being said, there may be a difference in renumeration if the donor has specific rare "traits" or attributes that might make his sperm more desirable/sought-after (much like when sires sperm are agreed upon when mating dogs - usually the donor is from a champion line.