March 15th, 2012
12:02 PM ET

Zakaria: 5% of U.S. patients account for 50% of health care costs

By Fareed Zakaria, CNN

New Jersey’s Camden Coalition of Healthcare Providers founder and family medicine practitioner, Jeffrey Brenner, used medical billing records to find that just 1% of patients accounted for 30% of health care costs in Camden. And that's not all he discovered in the city's three hospitals. He says: "We learned that someone went 113 times in one year. Someone went 324 times in five years. In similar workup in Trenton, they found someone who went 450 times in one year." These were people with complicated medical histories and chronic illnesses. One patient alone racked up $3.5 million in medical bills over a five year period. As Brenner says, :"They're the difficult patients to treat, and no one is being paid and incentivized to pay attention to them."

What's more, Camden's problem is America's problem. Just 5% of Americans accounted for half of our nation's health care costs in 2009. This is perhaps the crucial statistic to understand about America's health care problem.

So what should be done? I explore this in depth in Global Lessons: The GPS Road Map for Saving Health Care, which will debut on Sunday, March 18 at 8:00pm and 11:00pm ET & PT on CNN/U.S. it will air on CNN International on Saturday, March 24 at 9:00pm ET.  My companion article for TIME will be in the edition that hits newsstands on Friday, March 17.

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Topics: Health

soundoff (66 Responses)
  1. George Patton

    Fareed, I'd far rather see the money that we're wasting on the military to fund new weapons in order to kill more people spent on that 5% of the patients that you mentioned above. I know that health care costs here go up year after year and that's why we should try to emulate the Chinese health care system. We're all getting older too!

    March 15, 2012 at 5:22 pm | Reply
    • Johnco

      Yeah, spend all the military money on health care for everybody! You liberal and progressive children can never have enough. Take care of me Obama my mommie. Then after a few years we will be all dead (except you progressives that help the commies and Muslims), as the Muslims, Chinese and the Russians blast us off the face of the earth. By the way my wife is Chinese and lived under Mao's cultural revolution and beyond. She says the Chinese are preparing for war against us. Read this book as to what some in China think: Unrestricted Warfare, China's Master Plan to Destroy America. Of course this will be much easier since we have a filthy commie President in the White House. Yes a commie. My wife says he is one. She ought to know a commie when she hears one!

      March 18, 2012 at 10:44 pm | Reply
      • Mao

        oh, you are so smart ... you should run to be the next President of USA ...

        March 19, 2012 at 3:38 am |
      • Alex

        Johnco, I can only hope you never have to know the tragedy of being bankrupted by cancer or another terminal illness. Over 70% of personal bankruptcies are the result of medical expenses in the United States. Germany, Singapore, the UK, Canada, they all have single payer systems that work just fine.

        March 19, 2012 at 9:31 pm |
      • WyoGuy

        Your wife is definitely not an authority in international relations and claiming that Russia is preparing for war with the US just makes her a lunatic. I guess you found each other.

        March 19, 2012 at 10:47 pm |
      • Julie

        Yes, by all means lets kill everybody who isn't "us". No one's heart is bleeding, it's just common sense that we take care of our own. And just FYI the U.S. has at least 70% more military power than all other nations on this planet, so don't panic, whine or cry like a little baby if we take some of that precious "military" funding and re-invest it in living breathing American citizens. America take care of it's own or didn't you know that???

        March 19, 2012 at 11:08 pm |
      • Andrew

        you macaroon.... Obama's lowered the tax burden, cut thousands of public sector jobs and increased military spending. you simply aren't arguing with anything resembling reality.

        March 20, 2012 at 12:42 am |
      • GG

        I assume you also believe we are all going to die on Dec 21st 2012! Because your wife said Obama is a communist and because she said China wants to wage war against the US you are willing to sacrifice the lives of people that ARE going to die without that money. No speculation, no "if's", these people are ill and are going to die if things are not changed. But your right, building a bunker in the middle of the desert and living the rest of my life in fear sounds like a great 10 year plan. No amount of weapons/bullets/soldiers/bombs will ever fix the problems that Americans face. They will only continue to kill and hurt as humans have done for tens of thousands of years. Insanity is repeating the same mistake and expecting different results. So you, sir, are insane.

        March 21, 2012 at 9:05 am |
      • Educator


        Because your wife is Chinese you cannot seem to think beyond chinese. Learn how the health care is conducted in the countries that have the best happiness index (clue: look to northern Europe) you will see where Obama is trying to take us. Heck you might even fall in love with a swede or a finnish. That would not be good for your chinese wife. By the way the military budget is way out of alignment with the actual needs. 9/11 only helped Haliburton and could not be prevent with the largest military budgert in the world. Obama did away with Bin Laden with 6 marines and 2 helicopters. So think of military budget differently.

        April 12, 2012 at 12:56 am |
      • Matt

        Are you a Christian? I wonder what your response will be when Jesus asks you why you did not help him when he was ill?

        April 14, 2012 at 10:47 am |
    • Mike

      You’re an idiot maybe a move to china will do you some good.

      March 20, 2012 at 8:51 am | Reply
  2. Kerry

    What they need to do is to legalize euthanasia once and for all. I know that there are many invalides who, with no hope of recovery from a host of diseases will never live like humans and do not wish to be kept alive against their will. We need to let each and every human have that choice of whether to live or die in the end. After all, they do euthanize horses and dogs. This will help bring down the cost of Medicare as well.

    March 15, 2012 at 7:18 pm | Reply
    • WHAT!

      You first!

      March 18, 2012 at 7:40 pm | Reply
    • dammad

      Yopur solution is to kill people. Gee, I recall that being tired by such stalwarrt humaitarians such as Adolf Hitler, Josef Stalin, Mao. You're in good company with such other heroes as Margaret Sanger. A liberal by any other name is a murderer.

      March 19, 2012 at 7:16 am | Reply
      • Jennifer

        What you fail to note when you cry out against euthanasia is that no one (at least no sane person) is saying that it should be mandatory for anyone. No, a human should be able to "opt out" if their diagnosis is along the lines of "You're going to live in agony for an unspecified length of time and what little relief you'll find is going to drive you and your loved ones into deep debt that they may not be able to pay off after you die of this disease." If I were diagnosed with an incurable and untreatable disease that caused me lifelong pain and prevented me from even feeding myself, yeah I'd be the first in line.

        Euthanasia is not murder, it's a kindness we should allow our sick and elderly to choose for themselves. If you're invalid and driving your family into debt while slowly dying in agony but you insist on hanging on to the threads of life that remain to you, well that's your decision and I won't pretend that its any of my business.

        March 19, 2012 at 9:41 pm |
  3. CatCow

    We should legalize Assist Suicide. We have been wasting too much to extend those 5% of population to live a little bit longer. It is even worse in India. Low percentage of Indians can afford medical treatment. Out of these wealthy class in India, couple percents of them consume majority of India expenses. 2~3% of Indians consume 80% of India' medical resources.

    March 15, 2012 at 9:38 pm | Reply
  4. j. von hettlingen

    We in Scandinavia have a much better health care system and the people live a much healthier life.

    March 16, 2012 at 6:00 am | Reply
    • Paul Revere

      Says who? You and your Chamber of Commerce? Or did your government schools totally brainwash you. I imagine those 5% are dead on arrival in your country.

      March 18, 2012 at 9:01 pm | Reply
    • GreyGeek

      Is that why the elderly pin "Do Not Euthanize Me!" placards on themselves before they are taken to the hospital?

      March 19, 2012 at 11:52 am | Reply
    • john kerry

      Yes, you in Scandinavia ( I assume you are lumping all the countries together ) have a basically homgenous population of a few million who think that 180% registration tax on a car is a good thing to have. You ought to try 300 plus millions of many different cultures who live in a country dozens of times bigger than all your norse lands combined. Also you Scandinavian supermen pay FAR MORE TAXES than we do for your super health care- which pushes euthenaisa, abortion, and other population control methods, mind your own damn business about US matters and stay out of it. We still have a GDP bigger than all of you by hundreds of times and our standard of living, despite our problems is better.

      March 19, 2012 at 12:19 pm | Reply
      • BWF

        John really sound like an idiot.........

        March 19, 2012 at 9:15 pm |
  5. Intellibronc

    Ah, aint socialism grand???? I would venture to say, these vermin are under the age of 40,,,barrycare will destroy the greatest healthcare system this world will ever see...look at every single payer system, why do they come to America for surgery??? All R&D is done by companies NOT governments. And you swedish pukes,,,how many people live in your country 8 million? How's that diversity thing working out for you,,,say hello to allah for me....pukes....

    March 18, 2012 at 10:05 pm | Reply
    • daniel

      Thats false. Actually government does most the heavy lifting with regard to R and D. All the progress occurring in computing, nano technology, nuclear science, chemical sciences and a tsunami of other vital research interests only occur because governments invested in the research to allow companies to make short term profits.

      Every critical science gain be traced back to government involvement, including your microwave, fridge, laundry machine and even the material used that insulates your house.

      Government and private enterprise work hand in hand. With each other, not against each other. Always has been that way.


      March 19, 2012 at 3:49 am | Reply
      • dammad

        Your not listening. Who DOES the R&D?

        March 19, 2012 at 7:13 am |
      • GreyGeek

        Exactly, Daniel!

        After taxpayers fund research in thousands of areas, especially medicine and medical technology (36% in that areal alone), Congress passed laws allowing "monitization" of such research by giving it away for fractions of a penny on a Dollar. More often than not, the prinicpal researcher will make a fundamental breakthrough on the taxpayer's dime, but keep it secret, resign, find a venture capitalist to fund a startup, then buy the licensing rights from Uncle Sam. After a short period the startup announces their "new" breakthrough and begans marketing "their" discovery. Then begins the huge licensing fees that are part of why health care is so expensive. Even more dramatic are the increases in the costs of medicines as big pharma drops time-tested, inexpensive and effective medicines for their extremely expensive, less effective and even highly dangerous new drugs, because of the HUGE profit margins on them, guaranteed by patents from the very broken USTPO.

        Sixty percent of all health care costs are now covered by the US gov, and 46% of all bankruptcies were due to medical bills.

        My dad was taking brand name version of a blood pressure medicine made by Eli Lilly. It cost them $1.63 to make 1,000 tablets, and they cost my dad 30 cents apiece. Eli "discontinued" their brand name version and his doctor prescribed their more expensive "new" medcine at $3 per pill. It would jump his BP medicine costs from $10/mo to $90/mo. I told him to insist that the doctor write a generic prescription with no replacment option. That was 25 yrs ago. Now, those medicines can cost upwards of $300-$400 per month, leading some to taking them every other day or chopping them up into pieces and taking a piece of a pill a day. Some just don't take them at all.

        Medicine or treatment you can't afford might as well not exist. Those that can afford it often take "medical tourism" trips to Costa Rica, and other places, where they can receive excellent or better medical services at 1/10th of what it costs here in the USA. So, if given the choice of a $350,000 heart operation or a $35,000 heart operation, all other conditions being equal, which would you take?

        March 19, 2012 at 12:26 pm |
      • GotRevisionism

        So the government does all the R & D? hmmmm..... Here I am thinking that it was people in the private sector.... now I can give away my personal liberties so someone can exploit the existing medical insurance safety net. Thanks for the enlightenment. Elle MacPhartson should be sending back her millions for redistribution any time now too so that should help pay for it.

        March 19, 2012 at 12:42 pm |
    • John

      You sound intelligent.

      March 19, 2012 at 10:17 pm | Reply
  6. StreekyD

    Obama is my shepherd; I shall not work.
    He keepth jobs out of the hands of the people,
    Which leadeth the country to class warfare and polarization.
    He encourageth sloth; he leadeth the government to new heights in deficit spending.
    Yea, though I walk in the shadow of Economic collapse,
    I shall fear no depression: for Obama is with me.
    His handouts and monetary indiscretion supplement my income.
    He maintainest spending increases in the presence of insurmountable debt;
    He punisheth businesses with excessive regulations;
    And giveth the hard-earned fruits of labor to the unproductive.
    Surely, handouts and stimulus payments shall follow all the days of his administration;
    And I will stay unemployed forever.
    Lack of leadership, the first-ever federal credit downgrade, a failed debt deal, unemployment nearing record levels, fresh warnings of a double-dip recession, and the most toxic political climate in Washington history . . . can you trust President Obama?

    If you voted for Obumnuts in 2008 to prove you were not a racist, PLEASE for the love of God vote for someone else in 2012 to prove you are not and IDIOT

    March 19, 2012 at 9:28 am | Reply
    • wingnut

      The only thing worse than your ideology is your poetry.

      March 19, 2012 at 4:43 pm | Reply
      • BWF

        and he can't spell either.

        March 19, 2012 at 9:17 pm |
    • Julie

      Sure blame Obama – that's the answer, of course it's all his fault. Who else would be the cause? Oh, not W – hell no-You are the idiot! 🙂

      March 19, 2012 at 11:13 pm | Reply
      • Gaby

        Roger, I don't think that's really quite true. Oh, he may not be saniyg it with proper reference to your blog post, but looking through his plan, there are a whole bunch of things that directly touch on your points. Some of them, like the tax reorganization, just cut costs, but that would free more resources to pay for jobs, innovation, etc. Others, like the reduction in regulations, would encourage innovation directly - I know a lot of people who are in startups or who have run startups in the past who are finding additional financial regulation in particular are making new startups much harder to start up. The "Human Capital" part of the Romney plan specifically addresses retraining in a number of ways; I dont' see anything about teaching people specifically to be machinists and such, which we actually need, but retraining is specifically mentioned.In any case, the point is that I don't think it's factually correct to say "that neither candidate for president in the United States has articulated a good, substantive answer to this question." unless you're using the word "substantial" in a fashion unfamiliar to me.

        July 5, 2014 at 8:32 pm |
      • Nikki

        If government is not the asnwer, we should not expect politicians to have the asnwers. Recognizing this, government must get out of the way. The natural gas revolution came about without government. Productivity improvements from automation, technology, and process innovation do not rely on government. Removing tax, regulatory, subsidy, and other economic distortions because of government is what we need. Innovation and entrepreneurship come from creative minds and courageous investments, both of which depend on liberty. Without liberty, why bother?

        July 21, 2014 at 11:09 am |
  7. Doug Clark

    Ya, might as well cut off those with complicated medical histories and the chronic ill...they're really hurting the system. I mean seriously, they're obviously already very sick, you'd think letting them die would be a welcomed solution. It's a win/win for everybody. Well, except for the 95% of people left who might develop cancer, leukemia, suffer a spinal injury or anything like'll be out of luck next

    This is perhaps one of the most absurd articles I've read in some time

    March 19, 2012 at 12:50 pm | Reply
    • Maicon

      I found you in the magazine aticrle, too. I grew up on a farm with yearly gardens, and I have grown gardens in a lot of smaller plots as an adult. This year I want to dial it down to container gardening and see if less is more. Congratulations on your eight years! You must be doing something right and serving the needs of lots of folks way to go and to grow!

      April 21, 2012 at 12:49 pm | Reply
      • Open

        -4-JosA short answer is that lower pceird energy provides a stimulative effect on the economy, by making more money available that otherwise would be going to paying for energy. Because energy is so fundamental to economic activity, lower pceird energy can have a big economic effect. Shale gas in the US is the obvious example.A more complicated answer involves the need to trade off competing valued outcomes. Usually this sort of trade off is presented in Europe as energy vs. environment. It would be more accurate at the moment to characterize this trade-off as coal vs. gas!Cheaper energy would help the European economy. But getting it may harm other valued goals.

        July 6, 2014 at 10:48 am |
  8. Terry Moore

    Obamas Goals..
    A strong centralized government
    An executive arm growing at the expense of the legislative and judicial arm
    Control of banking, credit and security exchanges by the government
    Underwriting of employment through armaments or by public works
    Underwriting of Social Security by the government
    Underwriting of food, housing and medical care by the government
    Use of deficit spending to finance underwritings
    Abandonment of gold in lieu of managed currency
    Government control over trade, natural resources, transportation, agricultural production, organized labor unions, and youth corps-enlistments, to name a few
    A youth and people dedicated to the ideology of government authorities
    Heavy taxation of estates and incomes of the wealthy
    State control over communications and propaganda
    11 more months........VOTE

    March 19, 2012 at 2:15 pm | Reply
  9. Dan

    Whos the mutt Fareed Zakeria

    March 19, 2012 at 4:19 pm | Reply
  10. Dan

    Is there no standard anymore on television

    March 19, 2012 at 4:20 pm | Reply
    • Puia

      Marci, Impatiently waiting for the relasee of your book. Definitely want an autographed copy from the little girl who had a sunshine smile and lived on a farm and is an author, all grown up and beautiful still.Best of blessings to you in your testimony. God is truly Awesome.

      July 10, 2012 at 10:00 pm | Reply
  11. Efrain Ramirez-Torres MD

    On this issue of costs on health care no one has mentioned the malpractice factor in the equation...there has to be a difference between the countries Fareed mentioned and the USA - or is it irrelevant?

    March 19, 2012 at 9:10 pm | Reply
  12. Marie

    Will this be available for download on itunes??

    March 24, 2012 at 9:15 am | Reply
  13. Vinod

    It is a false hope to cut health costs by half by fixing the 5%. Unless economy is changed in a more fundamental way, the savings will be swallowed by the broken health sector and expenses will be passed on to the next 5%.

    March 24, 2012 at 10:03 pm | Reply
  14. Efrain Ramirez-Torres MD

    I will ask Fareed himself – any difference in the tort systems on those other countries – does it make a difference?

    March 31, 2012 at 4:50 pm | Reply
  15. Stock Bug

    "Only a few percentage of people use medical service!!!"

    This is a completely stupid argument. This is why called Health Care insurance. You need it when you have a problem. I am hoping only one percent of the people use it so that most of people are healthy. You do not want everyone sick. That will not be normal.

    April 14, 2012 at 8:34 am | Reply
  16. Benedicteb Gundwigw

    What i don't realize is if truth be told how you're no longer actually much more smartly-appreciated than you might be right now. You're so intelligent. You know thus significantly relating to this topic, made me personally believe it from numerous various angles. Its like women and men are not interested except it is something to accomplish with Lady gaga! Your own stuffs great. All the time handle it up!

    July 5, 2012 at 9:02 am | Reply
    • Joel

      .Jobs come from some enterprising iidnvidual seeing an opportunity to create wealth and hiring people to take advantage of that opportunity. The hiring decision is based on the expected bottom line of the person doing the hiring, be that a sole proprietor or a manager in some mega-corporation. With the Obama administration churning out tens of thousands new costly regulations it is little wonder that prospective employers are reluctant to hire when return on investment is both uncertain and likely to be negatively effected by regulations in the pipeline..

      July 7, 2014 at 3:27 am | Reply
    • Mizue

      I completely unsdaetrnd this objection and I too suspect that greater knowledge of the Higgs will likely never bring us great technological advance (or at least, not in the near future). But I also suspect this is the wrong question to ask that the benefits of pure science will in the future descend less directly from the science itself, but will still be inextricably linked to the research which bore it. Just as CERN brought us the web, and the space programme brought numerous technological spin-offs, I'm sure pure inspirational science of the future will reward us in ways we cannot now predict, but which stem directly from its pursuit (indeed, just as times of war always bring us medical advances). Apart from anything else, you can't bracket off different areas of physics, or even science as a whole, and treat them as isolated avenues of study the different disciplines will always talk to each other and augment each other's development. Matt is right to note that this is a horse race in which you can't pick the winner before it starts, but the truth is bolder than that whatever winners there are will emerge stronger from the participation of all the others.

      July 25, 2014 at 9:30 pm | Reply
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    August 10, 2012 at 6:02 pm | Reply
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