By: Drew Monger Research recently released by the National Institute for Health Care Management found severe concentrations of health care spending in the U.S. The bottom 20% of spenders only accounted for approximately 0.1% of overall healthcare spending while the top 1% of spenders accounted for more than 20% of overall spending. The highest spenders tended to be the elderly and those who suffer from chronic illness. Additionally, many of the types of illness the high spending groups face are the same as the types of illness the lower spending groups face, for both elderly and non-elderly patients, potentially making it difficult for doctors to initially identify who could develop into a high-spending patient. This fact highlights the difficulty of crafting policy mechanisms that lower the costs of health care.