The top 1 percent of all patients consume 22.7 percent of all health care spending, while the top 5 percent account for half of all spending, according to an analysis by the Agency for Healthcare Research and Quality (AHRQ).

The average annual tab for the elderly in the top 5 percent is $60,976, topped only by people with four or more conditions in the top 5 percent, whose yearly total is $78,198, says the AHRQ.

In contrast, people with private insurance in the top 5 percent average $39,542 a year, lowest of all in the top segment.