Symptomatic chronic diseases differ in their propensity for serious costly morbidity. Reliable and predictable deterioration presentations can be associated with very narrow margins between symptoms and the onset of serious complications. The inflammatory bowel diseases (IBD): Crohn’s Disease and Ulcerative Colitis are examples of this. As a result, they have high cost per capita with significant variation in that cost. Reliable metrics for assessing the relative volatility of chronic diseases are lacking.