About 5 percent of the population is responsible for almost half of all health care spending in the United States and for rising premium rates, according to a new report from the National Institute for Health Care Management Foundation.

U.S. spending for health care has been on a “relentless upward path,” the report claims, reaching $2.5 trillion in the aggregate, $8,100 per person, and 17.6 percent of GDP in 2009. Of the nearly $8,100 in health spending for each person in the U.S., approximately $6,800 (84 percent) went to cover personal health care services and products.

About half of the U.S. population accounted for only 3.1 percent of all expenditures, the report says. But 10 percent of the population is responsible for 63.6 percent of all health spending. The top 5 percent of the population accounted for 47.5 percent of all spending, and the top 1 percent accounted for 20.2 percent.

Not suprisingly, adults 55 and older made up a larger proportion of the high-spending group, while younger people tended to be in the lower spending group. Overall, people with at least one chronic health condition were two to four times more likely to have spending in the top 5 percent group, with the risk increasing as the number of chronic conditions rose. Obesity-related conditions played a part with significant spending as well.

Nearly half of people in the top 5 percent of health care spending had high blood pressure, a third had high cholesterol and a quarter had diabetes. Across the board (not just those with high medical spending), the five most expensive health conditions are heart disease, cancer, trauma, mental disorders and pulmonary conditions.

Higher spending for hospital care and physician and clinical services accounted for half of the increase in total national health spending between 2005 and 2009 and more than 80 percent of the increase in private insurance premiums over the period.

Instant Insights /

Report: 5 percent responsible for half of health spending

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