The five percent problem

What do you about the 5% of the population that accounts for close to half (47.5%) of the healthcare spending in the U.S? And 10 percent of the population for 63.6 percent of spending? In 2008, the ‘average’ person spent $233 versus the top half spending was $7,313 on themselves. Not surprisingly, it is the chronic conditions that are at the crux of the problem. Nearly 50% 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. (Fung A. National Journal June 27, 2011) 
Comment: Any solution to healthcare spending will have to focus on chronic conditions. Hence the current flavor of the month: medical homes. There has to be a multi-pronged solution to keeping chronic conditions from increasingly bankrupting the bank. Incentives for people taking care of themselves and disincentives for abusing themselves have to be part of the solution. Personal responsibility is entirely absent in the current reform legislation. All the risk is transferred to hospitals and physicians. Unless there is a financial penalty, a lot of people will not control their weight, lipids, blood pressure etc