Aaron Carroll is correct. You need to see this chart often if you are going to discuss health care. The very large majority of our health care spending is done by few people. Their spending will top any reasonable deductible that most people can afford. When beset with the kind of malady that really drives health care costs in our system, things like cancer, major heart disease or trauma, patients are not going to think about costs (for most people), but where they will get treatment. For the kinds of things that people usually talk about when advocate for higher deductibles, things like routine doctor visits, we are down on the left side of our curve.