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5 Percent Of People Account For 50% Of U.s. Health Care Spending

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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. health care spending has sharply increased over the past few years. Between 2005 and 2009, national health care spending rose by 23 percent from $2 billion to $2.5 billion, according to the NIHCM Foundation, a nonprofit, nonpartisan organization focused on health care. A foundation report that reviewed the 2008 Medical Expenditure Panel Survey found health care spending was concentrated among a small group of high-cost patients.

The report stated about half of the U.S. population accounted for only 3.1 percent of all expenditures. But 10 percent of the population hogged 63.6 percent of all health spending, the survey found. 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.

While the average person incurred about $233 in costs in 2008 for health care services, those in the top half of spending cost insurers, the government, or themselves $7,317. The top 1 percent cost $76,476.

Adults 55 and over made up a larger proportion of the high-spending group, while those in the lower spending group tended to be younger. The report also found that people with at least one chronic health condition were two to four times more likely to have spending in the top 5 percent group.

The likelihood increased as the number of chronic conditions rose. 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.

As health care spending rose, so did private health insurance premiums. During the 2005 to 2009 stretch in which health care spending rose, premiums for private health insurance increased by nearly 15 percent. According to the report, higher spending for doctors and hospitals is responsible for the growth in private premiums.

No sh1t. Fat old people suffering all sorts of self inflicted illnesses... be they psycho-somatic or genuine.

There is no money in the pot for that here either.

Oh well.

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Well duh hence the best possible system being one where the financial risk of being one of those 5% is spread across as many people as possible rather than onto the individuals who happen to fall ill.

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Well duh hence the best possible system being one where the financial risk of being one of those 5% is spread across as many people as possible rather than onto the individuals who happen to fall ill.

____________________________________

Your logic may be flawed.

Or perhaps you are taking the piss.

People are supposed to die.

____________________________________

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insurance is risk pooling - that's why people do it.

there is every reason for the govt to help people who are very poor to buy insurance, there is almost no reason at all for the govt to own and run hospitals schools etc.

there is definitely no reason that they should give themselves a monopoly in those areas.

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80% of your health care spending goes into the last 6 months of your life (source NHS) with very little change to the outcome.

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insurance is risk pooling - that's why people do it.

there is every reason for the govt to help people who are very poor to buy insurance, there is almost no reason at all for the govt to own and run hospitals schools etc.

there is definitely no reason that they should give themselves a monopoly in those areas.

Even when it is proven to be cheaper than the private system for the same outcomes?

Just because the right wing playbook says public providers = bad, private = good doesn't make it true

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80% of your health care spending goes into the last 6 months of your life (source NHS) with very little change to the outcome.

Very plausible. And I suspect that, by and large, those with the highest spend are precisely those who would be better off dead than undead, and who are kept 'alive' because it's establishment doctrine to do so and (in some cases) because the relatives feel better about it.

That's a much bigger skew than the 'merkin figure cited. I can see two reasons for that: one is that some[1] 'merkins aren't so obsessed with zombies as we are, and the other is that 'merkins have higher 'lifestyle health' spend that isn't heavily concentrated on end-of-life.

[1] Their law - and I expect practice - varies state-by-state.

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80% of your health care spending goes into the last 6 months of your life (source NHS) with very little change to the outcome.

I have heard the same statistic too.

The NHS gets slated for not wasting money on "heroic medicine" and gets accused of rationing care.

I think that the science supports a rational allocation of money compared to expected outcomes.

I also think that we expect miracles when those near and dear to us are in the situation where we hope that money can overcome science.

The NHS are in a terrible position in this regard as miracles do sometimes happen but the cost of one miracle is so large that it negatively impacts the outcomes for those who something much less than a miracle would still be a fantastic outcome.

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Very plausible. And I suspect that, by and large, those with the highest spend are precisely those who would be better off dead than undead, and who are kept 'alive' because it's establishment doctrine to do so and (in some cases) because the relatives feel better about it.

That's a much bigger skew than the 'merkin figure cited. I can see two reasons for that: one is that some[1] 'merkins aren't so obsessed with zombies as we are, and the other is that 'merkins have higher 'lifestyle health' spend that isn't heavily concentrated on end-of-life.

[1] Their law - and I expect practice - varies state-by-state.

I always point to the public healthcare system in Oregon. They look at their budget and all possible treatments relative to statistically observable outcomes every year.

They rank treatments and the expected number of patients who will require every treatment every year and draw the line at the point where they run out of money.

It is a very harsh but ultimately fair process.

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I also think that we expect miracles when those near and dear to us are in the situation where we hope that money can overcome science.

Yes, and that person getting the spend may be your 5 year old with some genetic disease and not just a chain smoking 80 year old lard gut. Who wouldn't try and shift heaven and earth for their own kids?

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Yes, and that person getting the spend may be your 5 year old with some genetic disease and not just a chain smoking 80 year old lard gut. Who wouldn't try and shift heaven and earth for their own kids?

Depends. You have to draw a line with sick kiddies too. If the condition is so bad they'll never have a life, then it's just as cruel to deny them death as it is the terminal cancer patient.

Oh, and in the case of a genetic disease serious enough to require substantial healthcare, the price for that healthcare should certainly be automatic sterilisation.

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Shall we shoot the sick to improve the stats?

If you have serious health issues you are going to need more care. Once you start suffering with ill health you are screwed.

So does this mean that nearly 5% of Americans lose everything paying for their health care? Although how many of this 5% or morbidly obese or worse?

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I have heard the same statistic too.

The NHS gets slated for not wasting money on "heroic medicine" and gets accused of rationing care.

I think that the science supports a rational allocation of money compared to expected outcomes.

I also think that we expect miracles when those near and dear to us are in the situation where we hope that money can overcome science.

The NHS are in a terrible position in this regard as miracles do sometimes happen but the cost of one miracle is so large that it negatively impacts the outcomes for those who something much less than a miracle would still be a fantastic outcome.

Indeed. I really get hacked off by all the media campaigns to get NICE and the NHS to shell out on exotic miracle drugs that have marginal benefit while people have to wait for simple cataract operations that are relatively cheap, are known to have very high success rates and can transform peoples lives. Of course, there is no money for big pharma in such outcomes which might explain why they don't get similar ramping in the press. Always worth remembering that medicine is big, big business where the outcomes are often hugely overhyped.

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I always point to the public healthcare system in Oregon. They look at their budget and all possible treatments relative to statistically observable outcomes every year.

They rank treatments and the expected number of patients who will require every treatment every year and draw the line at the point where they run out of money.

It is a very harsh but ultimately fair process.

That is the perfect rational system. You figure out how much money the society can allocate to this each year. Then give the bureacrats in charge that funding and orders to spend it in the most scientific way to maximize results.

If people want beyond that or to make the decisions themselves, then they should be free to pay for whatever they want done.

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80% of your health care spending goes into the last 6 months of your life (source NHS) with very little change to the outcome.

My mum works at an old folks.

You'd be shocked how many over 80s go in for various surgical procedures.

Thing is, most never recover from the shock and/or anaesetic.

Too many mental fit 80 yos go in and come out cabbages.

Its a total waste.

Best case its just practice.

Worse case its just churn to justify the hospital.

The NHS needs some form of rudimentary accounting system to see where and whom the money is being spent.

The reality is that it would be better to spend 10% of the money of better pallitive care - basically easing people off the mortal coil.

Of course that would mean we have a lot of redundant consultants and hospitals.

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No sh1t. Fat old people suffering all sorts of self inflicted illnesses... be they psycho-somatic or genuine.

An alternative interpretation is that few people have car crashes, but those that do incur heavy hospital costs.

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Imagine how much healthcare is going to cost when we all have a few spare organs being grown from scratch in a vat in our local hospital! Oh, and the hospital's computer is running a continuous, real-time, molecular-level model of every person's metabolism and can predict the date of your first heart attack from five years away.

And how big will the drugs bill be when everyone over 40 is on anti-aging medicine?

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I always point to the public healthcare system in Oregon. They look at their budget and all possible treatments relative to statistically observable outcomes every year.

They rank treatments and the expected number of patients who will require every treatment every year and draw the line at the point where they run out of money.

It is a very harsh but ultimately fair process.

We had a similar thing, it was called NICE. Did a very good job, too..

Problem is, we also have a brain dead tabloid press (and I would not be surprised to see a major industry lobbying campaign behind that..) which doesn't or won't understand that spending £X million of the latest 'wonder drug' which gives someone a few extra months of life is going to come at a cost to something else.

If I were completely cynical, I'd also suspect that some of the shock-horror reporting surrounding Dignitas and the whole right-to-die stuff is there at the behest of pharma company reps.

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Imagine how much healthcare is going to cost when we all have a few spare organs being grown from scratch in a vat in our local hospital! Oh, and the hospital's computer is running a continuous, real-time, molecular-level model of every person's metabolism and can predict the date of your first heart attack from five years away.

And how big will the drugs bill be when everyone over 40 is on anti-aging medicine?

At some point Society will have to change to focus on more medical and social care without the huge costs. Alas, US Capitalism focuses on healthcare for the wealty and they are trying to export it aroud the world. We need a Star Trek like change to how we perceive healthcare.

But I am shocked by many of the posts on here - presumably some of you have never been seriously ill yourself or have a close loved one who has been seriously ill. That day will come - then you might change your tune on the NHS.

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Imagine how much healthcare is going to cost when we all have a few spare organs being grown from scratch in a vat in our local hospital! Oh, and the hospital's computer is running a continuous, real-time, molecular-level model of every person's metabolism and can predict the date of your first heart attack from five years away.

And how big will the drugs bill be when everyone over 40 is on anti-aging medicine?

Well, if they can take a few of your personal stem cells and grow organs - or engineer cell lines with no immune-reaction causing antigens - then a lot of chronic conditions could be cured. If you could transplant the heart, lungs, liver, intestines, pancreas and major arteries in one block, you'd effectively deal with diabetes, heart disease and many currently-incurable cancers.

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  • 284 Brexit, House prices and Summer 2020

    1. 1. Including the effects Brexit, where do you think average UK house prices will be relative to now in June 2020?


      • down 5% +
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      • up 5%



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