This is a horrible way to frame the study's finding. "1% of people are responsible" sounds like some group is wasting resources, or taking up an uneven share.<p>The study looks at one year, and finds in that one year 24% of spending was on 1% of the people receiving care. That's not very surprising. 30 years ago I was in a bad car accident. I'm sure the cost of the ambulance, the emergency surgery, and the after-care was WAY more than most people average that year, and easily the most expensive medical year of my life. But it was just that one time.
Source link<p><a href="https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/#Share%20of%20total%20health%20spending,%20by%20percentile,%202021" rel="nofollow">https://www.healthsystemtracker.org/chart-collection/health-...</a><p>Don't assume high spending necessarily means poor overall health. Two people in my household are on modern fancy drugs for autoimmune conditions (upadacitinib and etanercept). They work spectacularly well and cost our insurance company thousands of dollars a month. And the family members taking them are doing great!
This comes as a surprise to whom exactly? Seems like the ideal scenario for ... insurance. Good health almost always costs nothing, but when an intervention is required, it's crazy expensive. -> everybody pays a negligible amount into the kitty. Since everyone pays in and almost noone takes anything out, there's enough there to cover crazy expensive treatments for the few who need them.
Yes. Thankfully we're not all seriously ill. And when someone does have that misfortune, we should spread the cost around, so that whomever needs care can get it.
I’m not sure how i feel about this statistic.<p>In America we have some pretty bed economics around health, i could easily see this number inflated by the exorbitant cost of insulin, or HIV meds, or cancer meds. life saving medications whose costs are quite controversial.<p>also, end of life care for the elderly. this is a statistic that needs some serious context and fact checking IMO
Is this over a lifetime or any given year? If it's the latter it's just a different 1 percent every year which will eventually include you. Clickbait framing of data.
Is this year by year? I’ve heard that we use something like half of our lifetime healthcare spending in our last years life. Which explains the numbers in the headline, but also shows why it’s misleading.
I doubt it's much different in other more social health care systems.<p>Some people just need a whole lot more aids and meds than most people. Take wheelchairs for example, they are as complex as single speed bicycles but easily cost 10k because reasons.
Well are the "people" responsible, or are outrageous-prices (e.g. one subscription costs 50k) responsible?<p>Or is it just like 1% of people have cancer?<p>Would love to see a good-faith analysis by somebody who has 50 hours to commit to it, a good grasp of statistics, and no interest in politics.
Isn't this just insurance?<p>Medicare takes care of the very very expensive end of life care.<p>but like, we all chip in, Some of us get very sick or hurt and there's no way to know up front who it might be. So, we all pay a little and that 1% is taken care of. Because that 1% might be me.<p>This is how it works. We could save money by sacrificing that 1%, but that's a pretty nauseating idea.
Careful. I smell inadvertant eugenics arguments approaching.<p><1% of people commit 99% of all murders. <1% of people cause 99% of fatal trafic accidents. <1% of people are responsable for 99% of tax fraud. <1% of people ride those stupid three-wheel bikes. If only we found and isolated 1% of people, all our problems would go away!
That's how the spending for anything work out when you have a wide spread in cost. This feels like a very unfair way to present a stat, blaming "people" for consuming more health care resources.
For most commercial companies you'll see pharmacy benefits split similarly: 1% - 2% of people on the health plan will account for ~50% of the pharmacy drug spend. That's regardless of overall health of the rest of the members. It's great there's been a lot of innovations for newer drugs that help more people with rare diseases, but specialty drugs just cost a lot. It takes a long time for generics or biosimilars can make it to market.
Is this total lifetime spending or per-year spending?<p>If it's per-year then the graphs are useless. You can be in the 1% one year, and in the bottom 50% the next.
I have a family member who used to be the director of an urban area's primary emergency department. (Now retired.)<p>At some point he and his administrative staff saw a similar trend, and also figured out that their top 10 most expensive patients were all people who had chronic health conditions and no health insurance or medicaid. Not having health insurance meant they couldn't effectively manage their conditions, which meant they were repeatedly getting to a crisis point and having a family member call an ambulance. Which is just incredibly expensive - all emergency services are - and of course if they couldn't pay out of pocket for a family physician then they couldn't pay for emergency services, either.<p>The solution was to start just paying out of the ED's own budget for these folks to see regular care providers, buying them their medications, arranging cab rides, etc. It saved the hospital millions per year.
Top 5% account for 50% of all healthcare spending.<p><a href="https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population" rel="nofollow">https://www.healthsystemtracker.org/chart-collection/health-...</a>
That is a statistic on one chart on that. For only those who are 65 and up, total spending of the top 1% drops to 17%. In the charts posted, from the ages of 19 to 44, the amount spent on women is much larger than on men (not sure why - obstetricians?)<p>Then of course, some people get cancer and some do not. With a normal age distribution of 18 year olds and up, it isn't surprising to me that very little is spent on the 18 to 30 year old men, and that one of the 65 and over got cancer and a lot of spending went toward that.
I would imagine this is roughly the distribution for anything that we use insurance for. What is the distribution of fire insurance payouts? Of auto insurance? If these thing were uniformly distributed, we wouldn't need insurance for them.
Wouldn’t this number be analogous (roughly) to any other country? My understanding is <i>who pays</i> differs in the US than e.g. Europe or Canada, but the amount of people in need of care shouldn’t be too different?
It would be better to separate chronic care expenses from acute care expenses. A lot of people have periods in their life where they need expensive acute care, but it's not chronic.
As I age I find myself increasingly becoming a healthcare spender. For a lot of people that's just a part of the chromosome shuffle and not so much about their life choices. But I can't say that. I've made very bad choices, over and over and over, knowing the consequences, across more than five decades now. My chromosomes are far from perfect but they would have done fine without my indulgences. Therefore I don't think it's right to impose my higher spending on the rest of you. I should just suck it up, walk it off, or suffer and die early, because it isn't fair for me to charge you for my pleasures. You don't owe me. I identify with the Inuit grandma choosing to drift off on an ice flow. But she has a much better claim on the support of her tribe.