The Concentration and Persistence in the Level of Health

Introduction Estimates of health care expenses for the U.S. civilian noninstitutionalized (community) population are critical to policymakers and others concerned with access to medical care and the cost and sources of payment for that care. In 2009, health care expenses among the U.S. community population totaled $1.26 trillion. Medical care expenses, however, are highly concentrated among a relatively small proportion of individuals in the community population. As reported previously in 1996, the top 1 percent of the U.S. population accounted for 28 percent of the total health care expenditures and the top 5 percent for more than half. More recent data have revealed that over time there has been some decrease in the extent of this concentration at the upper tail of the expenditure distribution (Yu and EzzatiRice, 2005).