American Medical News. ():, MARCH 5, 2012 Issn Print: 0001-1843 Publication Date: March 5, 2012 Print Who are the chronically costly? Health care's 1% Doug Trapp; + Author Information amednews staff. Checking for direct PDF access through Ovid Abstract The costliest 1% of patients consume one-fifth of all health care spending in the U.S., according to federal data. Health systems are trying to reduce the imbalance.