Half Of US Population Accounts For Only 2.9% Of Healthcare Spending; 1% Responsible For 21.4% Of Expenditures

Tyler Durden's picture

With the topic of peak class polarization once again permeating the airwaves and clogging up NSA servers, and terms like 1% this or that being thrown around for political punchlines and other talking points, one aspect where social inequality has gotten less prominence, yet where the spread between the "1%" and everyone else is perhaps most substantial is in realm of healthcare spending: perhaps the biggest threat to the long-term sustainability of the US debt picture and economy in general. The numbers are stunning.

According to the latest data compiled by the Agency for Healthcare Research and Quality, in 2010, just 1% of the population accounted for a whopping 21.4% of total health care expenditures with an annual mean expenditure of $87,570. Just below them, 5% of the population accounted for nearly 50% of all healthcare spending. Just as stunning is the "other" side: the lower 50 percent of the population ranked by their expenditures accounted for only 2.8% of the total for 2009 and 2010 respectively. Perhaps in addition to bashing the "1%" of wealth holders, a relatively straightforward and justified exercise in the current political climate, it is time for public attention to also turn to the chronic 1% (and 5%)-ers who are the primary issue when it comes to the debt-funding needed to preserve the US welfare state.

The spending distribution in chart format:

Broken down by age - While the elderly represented 13.3 percent of the overall population, they represented 47.9 percent of those individuals who remained in the top decile of spenders:

Broken down by sex - While women represented 50.9 percent of the overall population, they represented 61.6 percent of those individuals who remained in the top decile of spenders:

Broken down by race and ethnicity - Individuals identified as Hispanic and black non-Hispanic single race were disproportionately represented among the population that remained in the lower half of the distribution based on health care spending:

More of the report's findings:

  • In 2009, 1 percent of the population accounted for 21.8 percent of total health care expenditures and 20.5 percent of the population in the top 1 percent retained this ranking in 2009. The bottom half of the expenditure distribution accounted for 2.9 percent of spending in 2009; about three out of four individuals in the bottom 50 percent retained this ranking in 2010.
  • Those who were in the top decile of spenders in both 2009 and 2010 differed by age, race/ethnicity, sex, health status, and insurance coverage (for those under 65) from those who were in the lower half in both years.
  • Those in bottom half of health care spenders were more likely to report excellent health status, while those in the top decile of spenders were more likely to be in fair or poor health relative to the overall population.
  • While 15 percent of persons under age 65 were uninsured for all of 2010, the full year uninsured comprised 26.1 percent of those in the bottom half of spenders for both 2009 and 2010. Only 3.4 percent of those under age 65 who remained in the top decile of spenders in both years were uninsured for all of 2010.
  • Relative to the overall population, those who remained in the top decile of spenders were more likely to be in fair or poor health, elderly, female, non-Hispanic whites and those with public only coverage. Those who remained in the bottom half of spenders were more likely to be in excellent health, children and young adults, men, Hispanics, and the uninsured.

And the full report.

In 2009, 1 percent of the population accounted for 21.8 percent of total health care expenditures, and in 2010, the top 1 percent accounted for 21.4 percent of total expenditures with an annual mean expenditure of $87,570. The lower 50 percent of the population ranked by their expenditures accounted for only 2.9 percent and 2.8 percent of the total for 2009 and 2010 respectively. Of those individuals ranked at the top 1 percent of the health care expenditure distribution in 2009 (with a mean expenditure of $90,061), 20.5 percent maintained this ranking with respect to their 2010 health care expenditures.

In both 2009 and 2010, the top 5 percent of the population accounted for nearly 50 percent of health care expenditures. Among those individuals ranked in the top 5 percent of the health care expenditure distribution in 2009 (with a mean expenditure of $40,682), approximately 34 percent retained this ranking with respect to their 2010 health care expenditures. Similarly, the top 10 percent of the population accounted for 65.2 percent of overall health care expenditures in 2009 (with a mean expenditure of $26,767), and 39.7 percent of this subgroup retained this top decile ranking with respect to their 2010 health care expenditures. The data also indicate that a small percentage of the individuals in the top percentiles in 2009 and 2010 had expenditures for only one year because they died, were institutionalized, or were otherwise ineligible for the survey in the subsequent year.

In both 2009 and 2010, the top 30 percent of the population accounted for nearly 90 percent of health care expenditures. Among those individuals ranked in the top 30 percent of the health care expenditure distribution in 2009, 62.6 percent retained this ranking with respect to their 2010 health care expenditures (figure 1). Furthermore, individuals ranked in the top half of the health care expenditure distribution in 2009 accounted for 97 percent of all health care expenditures. Among this population subgroup, 74.9 percent maintained this ranking in 2010. Alternatively, individuals ranked in the bottom half of the health care expenditure distribution accounted for only 2.9 percent of medical expenditures (with a mean expenditure of $236 in 2009). Similar to the experience of the top half of the population based on their medical expenditure rankings, 73.9 percent of those in the lower half of the expenditure distribution retained this classification in 2010.

Given the high concentration of medical expenditures incurred by the top decile of the population ranked by health care spending (65.2 percent), identifying the characteristics of those individuals exhibiting significant reductions in health care spending in a subsequent year is also of interest. Among those ranked in the top decile in 2009 based on their high level of medical expenditures, 29 percent shifted to a ranking in the lower 75 percent of the expenditure distribution in 2010 (data not shown). Individuals ranked in the lower 75 percent of health care spending accounted for only 13.6 percent of all medical expenditures in 2010.

Individuals who were between the ages of 45 and 64 and the elderly (65 and older) were disproportionately represented among the population that remained in the top decile of spenders for both 2009 and 2010. While the elderly represented 13.3 percent of the overall population, they represented 47.9 percent of those individuals who remained in the top decile of spenders. For those individuals who remained in the lower half of the distribution based on health care expenditures over the two-year span, the elderly represented only 3.1 percent of the population. Alternatively, children (0-17) and young adults (18-29) were disproportionately represented among the population that remained in the bottom half of spenders (32.4 percent and 23.5 percent, respectively). In contrast, children and young adults represented only 2.1 percent and 2.9 percent, respectively, of those individuals who remained in the top decile of spenders. Individuals in the top decile ordered by medical expenditures in 2009 that shifted below the first quartile in 2010 were predominantly between the ages of 30 and 64.

Individuals identified as Hispanic and black non-Hispanic single race were disproportionately represented among the population that remained in the lower half of the distribution based on health care spending. While Hispanics represented 16.3 percent of the overall population in 2010, they represented 24.8 percent of those individuals who remained in the bottom 50 percent of spenders (figure 3). For those individuals who remained in the top decile of spenders, Hispanics represented only 6.0 percent of the population. Individuals in the top decile ordered by medical expenditures in 2009 that shifted below the first quartile in 2010 were more likely to be non-Hispanic whites and other races (74.9 percent) relative to their representation in the overall population (66.6 percent).

Individuals who remained in the top decile of spenders in 2009 and 2010 also differed significantly by sex, compared with those who remained in the lower half of the distribution ranked by medical care expenditures. While women represented 50.9 percent of the overall population, they represented 61.6 percent of those individuals who remained in the top decile of spenders (figure 4). For those individuals who remained in the lower half of the distribution based on health care expenditures over the two-year span, women represented only 43.3 percent of the population. Alternatively, men were disproportionately represented among the population that remained in the bottom half of spenders (56.7 percent). In contrast, men represented only 38.4 percent of those individuals who remained in the top decile of spenders. Individuals in the top decile ordered by medical expenditures in 2009 that shifted below the first quartile in 2010 were predominantly female (58.3 percent).

Health status was a particularly salient factor that distinguished those individuals who remained in the top decile of spenders. Overall, 2.8 percent of the population was reported to be in poor health in 2010, and another 7.8 percent was classified in fair health (figure 5). In contrast, of those individuals who remained in the top decile of spenders, 20.2 percent were in poor health and another 26.7 percent were in fair health. Furthermore, for those individuals remaining in the bottom half of spenders, only 0.5 percent were reported to be in poor health and 4.1 percent in fair health. Individuals in excellent health were disproportionately represented among those who remained in the lower half of spenders both years (41.2 percent). Alternatively, for those individuals remaining in the top decile of spenders, only 5.2 percent were reported to be in excellent health and 14.5 percent in very good health. Individuals in the top decile ordered by medical expenditures in 2009 that shifted below the top quartile in 2010 were predominantly in excellent, very good, or good health (25.8, 34.8, and 23.2 percent, respectively).

Focusing on the under age 65 population, health insurance coverage status also distinguished individuals who remained in the top decile of spenders from their counterparts in the lower half of the distribution. Individuals who were uninsured for all of calendar year 2010 were disproportionately represented among the population that remained in the lower half of the distribution based on health care spending. While 15 percent of the overall population under age 65 was uninsured for all of 2010, the full year uninsured comprised 26.1 percent of all individuals remaining in the bottom half of spenders (figure 6). Alternatively, only 3.4 percent of those under age 65 who remained in the top decile of spenders were uninsured. In addition, while 17.9 percent of the overall population under age 65 had public-only coverage for all of 2009, 32.6 percent of those who remained in the top decile of spenders had public-only coverage.

With respect to poverty status classifications, 36.2 percent of the overall population resided in families or single-person households with high incomes in 2010 (figure 7) and 15.2 percent had incomes at or below the poverty threshold. A lower representation of high income individuals (26.6 percent) and a higher representation of the poor (19.3 percent) were observed among those who remained in the lower half of spenders in both 2009 to 2010.

Source: The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2009-2010

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lunaticfringe's picture

Fucking government trolls, tht's who.

SWRichmond's picture

Okay. Who the hell junks that?

I didn't junk it but I beg to differ on all the raw veggies.  Mostly they just go through.  MOAR meat and cooked veggies. I am not a cow and do not have a cow's stomache.

Sudden Debt's picture

Last week I was in Moab Utah... and we where hungry so we checked out the local place to eat...

KFC, BURGER KING, TACO'S....

so because there wasn't anything real where you could eat we took KFC....

and when I orderd some of the most filthy greaced ass chicken you've ever seen... I DECIDED TO ORDER THE SALAD ON THE SIDE!!!!

now that was funny....

THE GIRL BEHIND THE COUNTER HAD TO CALL THE MANAGER BECAUSE SHE DIDN'T UNDERSTAND WHAT I MEANTH BY THAT!!!!

IT TOOK 10 MINUTES FOR THEM TO FIND SALAD!!!

I didn't eat it... it was like paper... and I took a bite from all the rest and decided it was a non eating day...

hedgeless_horseman's picture

 

 

When traveling, we go to the grocer, buy some food, then make our lunch.

hedgeless_horseman's picture

 

 

I doubt that the Shitty Mark-Up in Moab still has my photo posted, and a ban on me, but it is possible.

Uncle Remus's picture

In some locales, liqueur stores are called markets. Jus' sayin'.

Herd Redirection Committee's picture

Moab is great!  Hope you enjoyed it.  I camped there with my siblings a couple years back, and we visited all the Arches with my family back when we were kids.

Sudden Debt's picture

I loved it man. I was pretty damn sad when our vacation was over.
Normally I'm always happy when we're home after 3 weeks but not this time.
Giving back the rental car keys was a bad feeling.
I could already see myself retired and cruising through the US in a big ass RV :)

walküre's picture

OK, he's from Belgium. Nuff said.

Joe A's picture

Indeed, very good food there. And beer.

Buckaroo Banzai's picture

You're going to tell us they banned you, without telling us why? Sounds like there's a good story there.

hedgeless_horseman's picture

 

 

Broke college student + Coors + long week of mountain biking + bulk foods aisle + Coors + failed appeal to Mormon generosity + Coors + failed appeal to relationship with Prinster daughter + public nudity = gratitude for slow police response time

Herd Redirection Committee's picture

You were drunk and naked, threw up and passed out?  LOL

artless's picture

Ditto. I was just about to write that. I travel with my knives and some gear in a chef's knife roll up. Fits in a back pack. Buy some diposable tupperware at the local supermarket and you're good to go.

greatbeard's picture

>> I was in Moab Utah.

Were you lucky enough to make it over to Zion and Bryce?

hedgeless_horseman's picture

 

 

Risk On in Moab!

"Don't fuck up.  Don't fuck up.  Don't fuck up.  Don't fuck up.  Don't fuck up."

Sudden Debt's picture

Yep, did all the national parks starting from California, colorado, arizona, utah, ohio man it was super.
It was super, one of the most beautifull trips in my life. 24 days of seeing the most beautifull landscapes on earth.

Next year we'll do he east coast by car and I hope it will all be as good as this year.

greatbeard's picture

>> 24 days of seeing the most beautifull landscapes on earth.

When I decided to shit can society, I closed my business, sold everything, bought an RV and spent 7 months doing the same thing. Florida to Mexico, California, up into Northern Canada, Alaska, then on back.  It was the trip of a lifetime for me. Our RV was set up with a great solar system so we were able to dry camp mostly in National, State and Forrest Service camp grounds.   The problem now, even though I've got a bitchin hobby farm going is I just want to hit the road again.

azzhatter's picture

Ever notice the weight of a 4pc box of KFC? WTK is that, thing weighs like 5LBS- all grease

walküre's picture

Growing kale and wheatgrass. Kale chips and wheatgrass shots are on the daily diet in our house. Feeling fit and strong.

Here's the US conundrum in a nutshell

Food stamps are directly supporting P&G and other mega food corps

Obamacare is directly supporting Pfizer and other mega drug corps

US rabbits are the test monkeys in the United States of Dumb.

Can't say they're trying to hide it from us.

DaddyO's picture

Just a little plump, that's all...it's not her fault, bless her heart.

She's just suffering from a slow metabolism afterall...just ask her.

DaddyO

mkkby's picture

Holy shit.  Does she really look like that or is it a photoshop hit job? 

I haven't seen her since the first inauguration -- no TV.  Back then she wasn't a pretty girl, but fairly slim/trim.

Joe A's picture

The trouble with health problems such as obesity, diabetis, etc. really started when sugar was replaced with corn syrup as a sweetener and using transfats instead of polyunsaturated fats. Both are highly addictive and highly destructive. But good for sales of soda and junkfood!

Herd Redirection Committee's picture

And to up the addiction levels, they put MSG in everything.  Its even in Tim Hortons coffee up here in Canada!

Then they brainwash you with commercials, to 'remind' you of the social status you can have, just by consuming certain products (iPhone 5, any one).

Joe A's picture

MSG in coffee??? By a lack of taste of the coffee they add a taste enhancer?

Don't get me started on GMO...

Lux Fiat's picture

Yes, after becoming aware of the issues with MSG, I started checking labels on some items I bought for those nights when I needed to fix food in a flash.  I didn't expect to find it in instant mashed potatoes, mac n' cheese, soups, stuffing mixes, jerky, etc.  Most things now are made from scratch, and prepared items must have a pretty simple ingredient list or it never makes it to check out.

W74's picture

No shit.  How'd I miss that article?  That's right up my interest alley.

RaceToTheBottom's picture

High frucose corn syrup is up there on the evil coeff. but also wheat.  I have Gluttun alergies in the family so avoid it and have expanded to remove wheat as well.  Great idea.

CPL's picture

Don't miss on some of those other Amino acids your body needs to mentally function as well.  It doesn't have to be animal protein either.  Head to a bulk barn and get Quinoa seed and plant some for the next year.  Hard to kill (drought, cold snap, too much water).  Complete protein.  Tastes like oatmeal.  Add it to burger mix/bread/stew/etc.  Makes a better corn meal than corn meal.  AND it's a nitrogen sink like clover which pulls nitrogen from the surrounding atmosphere. 

When you've finished harvest, till it under and there's your shot of starter fertilizer for the next season after a winter.  My experiment this year yielded around 3700 lbs of per acre averaging with a top end of 4300 lbs per acre and 2000 lbs because the deer got into a patch near the forest boundary. 

That last part was my fault though, I didn't take the dog to walk the tree line enough to mark the territory.  If you have problems with pests in a patch, you get a male dog to piss all around the area you want covered.  The animals around the area smell 'wolf' and stay away from the 'wolf's' hunting area, doesn't matter if the dog is 150 pounds or 2 pounds.  Male dogs smell like wolves to forest nibblers.  For birds, the high technology of a pie plate tied on to a stick keeps most of them out. 

Suppose it depends how aggressive you want to get.  2000 lbs an acre is still serious business and keep in mind it produces enough for nature to take it's cut and leave tonnes of food left over for the person growing it.

@ 3.00 a pound it's cheap in terms of seed cost.  As a food it's half the price of hamburger and the same amount of protein so if you lift/workout you'll see the gains quickly if looking to gain.  Leaner muscle gain and recovery seems to improve a bit, nothing spectacular though but better than nothing.  If you've got IBS, it's easy on the guts to break down and process.  If you get over the fact it's tasteless and know how to cook with spice, it's dead easy to use as a filler.  Word to the wise though; Chili is disgusting with it unless you fry it up with meat and seasoning first.  Soups/stew are great.  Best though is Indian and Chinese cooking.  Ginger, garlic and quinoa were just built to work together on a palette.  Or rosemary, sage and onion.

Quinoa is also very pretty and smells nice, hard to describe 'clean/fresh' as a smell but that's what it smells like.

Herd Redirection Committee's picture

Good stuff, CPL.  I always walk in the woods with my dog, and we tend to stick in the same areas.  My basic idea is what you stated above, to let the critters know this is our territory. 

I'm not afraid of wildlife,  I just don't want to surprise them!

walküre's picture

Yes, Quinoa is a staple around here as well. Replaced potatoes and white rice.

Miffed Microbiologist's picture

Very informative CPL. Considering how much .22 ammo we've burn through on shooting rabbits I'm thinking I should try your method. We only have female dogs. Does human male urine work? ;-)

Miffed;-)

CPL's picture

Train one of the bitches to run rabbits, most dogs are built to do it unless they are pocket sized.  If pocket sized, they bravely face spiders, houseflies and laser pointers. 

And unfortunately nope, people pee doesn't do much.  Falls under the don't shit where you eat and sleep category.

I am a Man I am Forty's picture

Bought a vitamix a couple weeks ago, throw some spinach, kale, apple, cucumber, lemon, and stevia together, blend it, and drink that for lunch during the week.  Good stuff.  Too bad I am still a weekend warrior but a step in the right direction.  That and excercise 5 days a week maintains chubby.

Miffed Microbiologist's picture

I do the same and vary the veggies to what's in season. The lemon is critical because it takes away the heavy green grass flavor most people can't get around. I was in a group when the conversation turned to bemoaning being over 50 and being constipated all the time. I told them this wouldn't be an issue if they juiced. " Why would you drink that icky drink when you can just take a pill?" was what I got. I had to leave the table and have a shit.

Miffed;-)

pods's picture

Good call on the Vitamix, we have had one for like 3 years. We make shakes for breakfast.

Our go to recipe:

Half to 3/4 pound baby spinach, a cup of blueberries, cup of seeded grapes, apple, strawberries or mango in season (not the seed), couple bananas, and a quarter cup of ground flax.  The flax is needed to help with bio-availability of the fat soluble vitamins.  Then we add some ice to cool and maybe a cup of juice. We have used OJ and now usually use a juice blend.

This will fill the 64 oz. I add the bananas after beating down the spinach as it is too full before.

pods

Buckaroo Banzai's picture

I like the Green Power juice extractor myself. Vitamix is great but I don't need to ingest all that fiber. I make poopies just fine without it.

pods's picture

Yeah there is a lot of fiber. We also use it to process the garden into sauce.  We ran 75 lbs of tomatos into sauce in an afternoon.  No skinning needed. And making nut milks as well as ice cream for the kids.

And in leisure time it makes margaritas in about 6 seconds. 

pods

CPL's picture

If you are feeling well and your body likes hanging onto a couple of extra pounds plus some excerise.  Who cares. You really can't ask for better than that.  It's just extra fuel for the sex machine.  ;)

http://daddytypes.com/archive/suns_out_guns_out.jpg

Herd Redirection Committee's picture

One of the most dangerous men of all-time: Fedor Emelianenko, agrees with you.

zapdude's picture

Yup, we love our Vitamix too. 

Throw a whole pineapple in there (excluding the skin) with oranges and bananas for awesome & fiber-filled smoothies.  So many good & simple recipes.

You can even make tomato soup in it -- no cooking required, the blender heats it up all by itself through friction alone!

W74's picture

I've been touting on other forums the fact that Big Pharma meds are turning people into zombies, that they never actually cure and instead prolong illness, and that the side-effects (known and unknown) are more than likely worse than any condition currently being experienced.

Of course you get called the tin-foil-hat conspiracy theorist guy.  So much the better though, since there are plenty of people who DO understand.

Herd Redirection Committee's picture

They make money from TREATMENT.  Ongoing, continuous, treatment.

ADHD, diabetes, depression.  They love that shit!   They wish more people were diagnosed with those diseases!

nuclearsquid's picture

Good advice, but animal protiens are visibly underrepresented in your 'eat well' picture.

Bunga Bunga's picture

What, no antibiotics, pink slime, aspar-tame? You want to destroy the health care industrie - that's unamerican.

Boondocker's picture

I didnt junk you but i am not sure everyone is bred to run.  Walk and hike, heck yes!!!!