Ever thought to yourself, "Man, I know a small number of patients account for an inordinately high percentage of total spending, but I sure wish I had a graphical representation of the breakdown?" Uh, me neither. But I'm glad Kaiser created one anyway:
You want to slow health spending? You have to slow it on these patients. HSAs and their brethren like to pretend that by forcing caution on when you get a test for strep throat, we can significantly effect health costs. Not so. HSAs have a spending cap, and once it's broken, all care is covered. They do nothing but disincentivize basic care, which doesn't cost much anyway.
Instead, you're going to need to attack these costs at the top. You may need to ration. You'll definitely need to cut down on wasteful care. You'll definitely need to erase the payment structure that encourages doctors to prescribe the most intensive treatments. You'll probably need to give the government bargaining power so we begin paying less per unit of care, as all other countries do. More here.
