The Healthy 1%

Some attention has been focused on a recent analysis that health care costs are highly skewed. Apparently, 1% of patients accounts for a fifth of all healthcare costs. For half of us, our healthcare costs are only a few hundred bucks a year. For the top 1%, they exceed $100,000.

I’m not sure what the point of this is. The very idea of health insurance is to insure against catastrophic illness. $100,000 is the cost of a moderate to bad health problem. That 1% is not a static group; people move in and out as they get sick or healthy. We don’t need government to tax us all to help people pay bills; that’s what insurance does. The only impact his has on the healthcare debate is to either link mandated coverage with mandated purchase — i.e., prevent people from waiting until they’re sick to buy insurance. It could also argue for high-deductible plans that only cover disasters.

Naturally, this is being used to argue for all kinds of other things. Preventative care is a big one. But as I’ve noted, preventative care does not save money even if it saves lives. It’s also being used to argue for end-of-life planning, which I support but is unrelated to this.

Really, I don’t know this stat has suddenly become so big. Healthcare doesn’t cost much until you need it. We knew that, didn’t we?