I'm not entirely sure I'd want this. It sounds like some penultimate god-spell that requires everything of everything. I'd much prefer there to be a diverse amount of very strong spells that are perhaps the combination of two, three elements at maximum.
No single channeler should ever be the ultimate mage of all the elements at once. You should always have to make a choice as to what you're going to have access to. Do I want fire or earth? Do I want air or water? Where do I specialize? Not just "I'll take it all".
Well, by my understanding of midaeval medicine and the Elemental cover art, the fith element is actually a combination of all four others. Therefore, I suppose a five-element spell would also require essence to work.
I don't see what medieval medicine has to do with it, but in Elemental, the fifth element apart from Earth, Air, Water and Fire - is 'Life'.
In the classical interpretations of the elements, the fifth element is usually "aether", "space", or "void" - depending on who you ask. But none of them appear to be a combination of the other four elements.
I looked at the cover art and thought of the classical earth/water/air/fire system, and it looks like "life" is in fact the sum of the other four. Life also makes me think of essance, hence the essence cost.
And of course, I'm completely blind, missing this post until I've already written a reply. Blah.