The concentration of health expenditures: an update.

An earlier study tracing trends in health spending from 1928 to 1980 found health expenditures concentrated among the top 1 percent of those spending money for health care. In an update to that study, the authors found that that trend toward concentration has increased. In 1987 the tope 1 percent of spenders accounted for 30 percent of health spending, up from 26 percent in 1970 and 29 percent in 1980. In contrast, the bottom half of the population in terms of spending accounted for only 3 percent of total spending in 1987. The average expenditure for the top 1 percent of spenders in 1987 was $47,331. Nearly half of those top spenders in 1987 were elderly. Also, more than 16 percent were black, up from nearly 10 percent in 1980.