Health Costs – the inverted Iceberg of healthcare expenditures in the USA

Posted by Dike Drummond MD

health costs healthcare expenditures upsidedown iceberg 150x150Health Costs in the USA
What does the Inverted Pyramid mean?

A recent report by the Agency for Healthcare Research and Quality (AHRQ) confirmed health costs distribution across the patient spectrum first reported in 1996 that are mind boggling and – at the same time – not unexpected by practicing physicians.

  • The top 1% of Patients account for 28% of all health care expenditures
  • The top 5% account for 50% of all health costs

These statistics were true in 1996, 2008 and 2009

Here is another important stat
The top 30% of Patients accounted for 89% of health costs in both 2008 and 2009.

Nearly 90% of the healthcare dollars spent in the USA in those two years went to 30% of the population.

In 2008 the bottom 50% of the population accounted for only 3.1% of the health costs.

I have a personal inkling that this health costs distribution correlates strongly with the long understood Medicare trend of most Medicare dollars being spent in the last 6 months of life and doctors long documented habits of reluctance to discuss end of life issues with patients.

What do you think these statistics mean and what would you propose to address these health costs issues with the top 5% of utilizers?

Put your comments below and lets discuss.

[ here is a link to the original AHRQ report ]