5 Percent Account for 50 Percent of Health Care Spending

In 2008 and 2009, 5 percent of the population was responsible for 50 percent of the total amount spent on health care, according to a study by the Agency for Healthcare Research and Quality (AHRQ).  During the same time period 50 percent of the population spent only 2.9 percent of the total amount of $1.26 trillion spent on health care in 2009, meaning that most health care expenditures were made by a small group of people, and the great majority of people do not spent a lot on health care.

Of that top 5 percent the average amount spent per person on health care during 2008 was $35,829 and the average amount spent by an individual in the lower 50 percent during 2008 was $232.  A health care expenditure was defined as the total expenses as the sum of payments from all sources to hospitals, physicians, other health care providers (including dental care), and pharmacies.  Thirty-eight percent of the individuals who were in the top 5 percent of health care expenditures remained in that category in 2009.

 Insurance Coverage

 Interestingly the 5 percent of the population that spent over half of the total health care expenditures were mostly insured with a large percentage receiving coverage under either Medicare or Medicaid, and the greatest number of uninsured were among the group that spent the least on health care in 2008 and 2009.

AHRQ reported that only 3.6 percent of those under age 65 who remained in the top group of spenders were uninsured. Of those who were 65 or older, 31.0 percent had public only coverage.   Public only coverage was defined by AHRQ as either Medicare or Medicaid.

The greatest number of uninsured were in the category of low spenders on health care services in 2008 and 2009.  While15.5 percent of the overall population under age 65 was uninsured for all of 2009, the full-year uninsured comprised 25.9 percent of all individuals remaining in the bottom half of spenders.


Individuals who were between the ages of 45 and 64 and the elderly (65 and older) were disproportionately represented among the population of top health care spenders for both 2008 and 2009. While the elderly represented 13.2 percent of the overall population, they represented 42.9 percent of those individuals who remained in the top group of health care spenders.

Females represented 50.9 percent of the overall population but represented 59.0 percent of those individuals in the top group of health care spenders.  Males comprised 58.4 percent of the bottom spenders of health care.