Health Care Spending

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Here's another interesting blog from The Incidental Economist.

"Posted: 31 Jul 2012 07:00 AM PDT

This is from the NICHM, in their recent brief, “The Concentration of Health Care Spending“:

That’s the cumulative distribution of personal health care spending from 2009. There are so many ways to talk about this. One thing to note is that the top 5% of spenders (some of the sickest among us) account for about half of all health care spending. More significantly, the bottom half of spenders (ie the healthier half) account for less than 3% of all health care spending.

When we talk about incentivizing people to forego care, we’re talking mostly about healthy people. When we talk about consumer directed health care, we’re talking mostly about healthy people. We don’t want sick people to avoid care. We want to stop healthy people from consuming it. The problem is that healthy people consume so little care to begin with. If we could incentivize the healthier half of people to forego all their personal health care spending, we’d spend $36 billion less out of a total $1.259 trillion in personal health care spending. That would be a drop in the bucket. And no one – no one at all – thinks we can get people to stop all their health care spending.


Wow-the top 5% account for 50% of health care spending. Healthcare cost control is a complicated issue.

Jun. 29, 2012 9:24 am


All the screaming about "death panels" during the debate over the ACA ... er, Obamacare ... was misguided, and unfortunately effective in preventing us from taking care of part of this problem. The end of life counseling, as i think it was called then, was intended to help the family of the elderly determine which procedures were worth pursuing, and which were just going to prolong the suffering of the patient while consuming countless additional hours of doctors and nurses time and materials.

Things get to the point where you just have to let go. Our doctors and medical staff are trained to make their patients well again, not to determine which tests or procedures are economically feasible ... that is not their job, and never should be. That is where the counselors proposed by the ACA would come in, to help the family decide what to do. No death panel would be there to make the decisions or to deny or ration care, only the family of the ill, once educated about the chances of success of the options presented.

It's a shame that the hysteria ginned up by all of the lies about "killing Grandma" has left us still in this position. It's ironic that people from the same so-called right were behind the death panel lies during the ACA debates in congress and the town halls and in the media, but they have been largely silent about the death panels of Jan Brewer in Arizona that have denied organ transplants to Medicaid patients. At least 2-3 of these patients that were denied transplants have since died while waiting for the state to reverse this cruel decision.

Jul. 7, 2011 11:13 am

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