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5% of Americans Made Up 50% of U.S. Healthcare Spending

And the top 1%? They made up one fifth of medical expenditures. 


615_Health_Spending_Shutterstock_Scott_Hales.jpg

Shutterstock / Scott Hales

When it comes to America's spiraling health care costs, the country's problems begin with the 5%. In 2008 and 2009, 5% of Americans were responsible for nearly half of the country's medical spending.

Of course, healthcare has its own 1% crisis. In 2009, the top 1% of patients accounted for 21.8% of expenditures. 

The figures are from a new study by the Department of Health and Human Services, which examined how different U.S. demographics contributed to medical costs. It looked at the $1.26 trillion spent by civilian, non-institutionalized Americans each year on health care.

The top 5% of spenders paid an annual average of $35,829 in doctors' bills. By comparison, the bottom half paid an average $232 and made up about 3% of total costs. 

Aside from the fact that such a tiny fraction of the country was responsible for so much of our expenses, it also found that high spenders often repeated from year to year. Those chronically ill patients skewed white and old and were twice as likely to be on public healtcare as the general population. 

The graph below looks at how many people remained in each tranche of healthcare spending in both 2008 and 2009. One fifth of the top 1% of healthcare spenders in 2008 also were in the top 1% a year later. More than a third of those in the top 5% stayed there both years. 


Persistence_Chart_HHS.jpg

According to this follow-up chart, elderly patients, aged 65 or older, made up 13.2% of the population in 2009. But they were 42.9 of the patients among the top 10% of spenders in both 2008 and 2009. Middle-aged Americans made up another 40.1% of that category. 

Distribution_Chart.jpg

America's healthcare spending crisis is a concentrated phenomenon. The challenge isn't just about making everybody's insurance cheaper (although that would be nice). It's about figuring out how to cut costs, wisely and fairly, for the disastrously ill and preventing diseases before they become chronic. This is America's 5% problem.





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  • Teresa  •  Hershey, Pennsylvania  •  1 month 6 days ago
    I am 43..and have Cancer...and had to lose EVERYTHING to get care...doesn't seem fair. But the care is there....if a catastrophic illness hits. But be prepared to lose it all. Medicaid isnt forgiving. And will take whatever you own..upon your death..to pay for medical debts you incur..while you are alive. But i have the BEST care right now. And the pain relief..is worth losing everything...to gain sanity against excruciating pain..that will DRIVE you out of your mind!!! Cancer...dont discriminate!!!! ..I had radiation on Friday. I am finally feeling human. But who knows when death claims you. I'm allowed to go. I dont have kids. So if they have to euthanize anyone. I volunteer!!! To save money!!!! (not scared of dying..just terrifed of pain)
  • GoodeFourNothing  •  1 month 6 days ago
    I realize that the example I am about to share is just that - an example, and in no way representative of the whole - but my father in law is an ER doc on the south side of Chicago, and his experience has been that the majority of his patients do not need to be in the ER at all. They come in (by ambulance, of course) with colds, nosebleeds, hangovers, upset stomachs and not only do they request further testing, they DEMAND it. Then they DEMAND drugs, when all they really need is to take 2 aspirin and to make better life choices.

    And do you think they have insurance? Hardly...but they know that they can get away with using the ER as their medicine cabinet without having proof of insurance, because the ER is required to treat them regardless. But then, what's the alternative?
  • Michael  •  Columbus, Ohio  •  1 month 6 days ago
    We all need to be aware of the fact that many of these elderly and sick people probably worked and paid for health insurance for many years. Now that they have grown old and need healthcare in the last few year of their lives, the focus is on how to cut healthcare costs for them. If they paid into the system during their healthy and productive years, then they deserve to receive the care that they need in their senior years.
  • iansmeema  •  Southfield, Michigan  •  1 month 6 days ago
    Mark my words - we're being prepared for denial of service to patients who "take more than their fair share of services". We're about to find out how many dollars a human life is worth.
  • Jan  •  Dayton, Ohio  •  1 month 6 days ago
    Was Medicare fraud considered when these numbers were collected?
  • eagle71  •  Tracy, California  •  1 month 6 days ago
    Idiots, old people have always needed more care than the young. Next comes the middle aged. The only point of this article is to induce jealousy and rage at another 1% group. Open your eyes people!
  • Paul R  •  1 month 6 days ago
    Imagine that. Older people spend more on healthcare. What a pointless article.
  • Donna  •  Dallas, Texas  •  1 month 6 days ago
    Thanks to advancement in medical technology and medications...we are living longer...it is a no brainer those 65 and older are eating up medical costs...but I have to admit...you go to any ER in a larger City...especially a County (taxpayer funded) hospital who are all those people and kids abusing the ER??? And you will find...illegals are getting cancer care on the taxpayer. US citizens 65 & older are easily tracked....but illegals aren't....

    I don't think this article is really accurate.......if it does not include "everyone" who is getting care in the USA.
  • jennifer  •  Mokena, Illinois  •  1 month 6 days ago
    As a healthcare provider, I can honestly say the first thing that needs to change are the people who abuse our healthcare system. Why are patients on public aid allowed to go the ER for a pregnacy test? Or parents who bring their kids to the ER for a fever but don't give them tylenol or motrin before they come in because they can get the meds for free in the ER. And please don't tell me they don't have money, they can barely put down their iphones to tell us that their kids are sick. I became a nurse because I wanted to help the sick, not babysit the entitled
  • john  •  Cicero, Illinois  •  1 month 6 days ago
    Most of these old white people paid into medicare every payday there whole life and are now just using the services they have paid for there whole life. Maybe you should ask how much is spent on healthcare for illegal alliens every year instead of whining about the cost of hard working Americans that have worked there whole life and paid into the system and are now asking for what they paid for .
  • Citizen  •  1 month 6 days ago
    So for those of us who have paid and paid for years and barely use it, we should get Roll-Over-Minutes back.
  • Citizen  •  1 month 6 days ago
    The benefits keep degrading while the premium ever rises. We won't even be able to use it when you're older because the co-pays and deductibles will break you. Fact.
  • forrest p  •  La Vergne, Tennessee  •  1 month 6 days ago
    I'm all for helping the elderly as much as we can and of course children. However, you have deadbeats who abuse the emergency room. I read a story last year about a homeless guy in Dallas who went to one emergency room like 30+ times in one year. None of the visits really constituted an emergency. Every hospital has people like this who abuse the deal and have no intention or way of paying for the visit. Something has to change. We can't keep propping up deadbeats.
  • Greg  •  Fort Wayne, Indiana  •  1 month 6 days ago
    I went through chemotherapy and radiation. With how much those alone cost my insurance(thankfully, not me besides all the copays), this article just seems like common sense to me. when my proton radiation billed my insurance for millions,for just me, 1 person, of course a small group of people are gonna account for most the spending.
  • Pertnear  •  1 month 6 days ago
    So, the illegal patients are not included in these numbers? Why not?
  • Bob  •  1 month 6 days ago
    Visit ANY Los Angeles hospital ER, especially during flu season. The number of non-English speaking patients wanting full exams and flu shots is staggering. And the hospitals can't turn any of them away. In the summer they're filled with the same patients suffering from shootings, stabbings, assaults, traffic accidents, drug overdoses. The only ones you don't see in the inner city hospitals are the homeless. They only go there to die.
  • Marine Dad  •  Lancaster, California  •  1 month 6 days ago
    HUH? You didn't address WHO was the 5%, but then again you HAD to interject how much the '1%' paid.

    I will tell you, from debt-ridden-soon-to-be-flushed-down-the-toilet-like-Greece California, the biggest leach on services, including health care, is the ILLEGAL population.
  • Christopher  •  Tucson, Arizona  •  1 month 6 days ago
    Several years ago I read that over 75% of health care costs were from the last 6 months of life. In other words, spend huge amounts to pretend you are going to live. When I get terminally ill, cut the costs out and let me go.
  • DM  •  Elkridge, Maryland  •  1 month 6 days ago
    Pull the plug, I've already instructed my wife what I want - not to be a burden and not to waste $$$ to extend my life a few months. I'd rather children be vacinated against disease, thank you very much.
  • The Chief  •  Tampa, Florida  •  1 month 6 days ago
    I've been an ED nurse for the past 30 years and the two things that I have seen in that time that contribute most to the problem of being healthy is smoking and obesity. Not to say there aren't other problems contributing to the general overall decline in our nations health, but these are the top 2 problems I have seen over the years. Just saying.....
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