In the last weeks, there’s been a lot of discussion in the news of rising costs in the health care industry overall, and in cancer treatment specifically. Between 1990 and 2008, the cost of cancer care has leapt from $27 billion all the way to $90 billion each year, writes USA Today. Much of the jump has been driven by the very thing that is helping more people live longer advances in medicine. Nowadays, there are dozens of new therapies, treatments, and gadgets that can add months or years to a patients’ life, and many more people taking advantage of those treatments. The “number of breast cancer patients receiving chemotherapy doubled” over the 1990s, and that number has only continued to rise. This has led to doubled costs, and new drugs have added even more to that. Many of the latest treatments, such as the drugs Avastin and Erbitux, cost tens of thousands of dollars per year, edging into six figures at the high end. They have brought death rates down by 16%, but at a very high cost in treatment on top of the $100 billion devoted to research since 1971, says an article on Bloomberg News. “The rising cost of cancer research and care, which helped reduce death rates by 16 percent over 40 years, is straining the U.S. health system and needs to be restrained,” wrote the journal of the American Medical Association.

These high and rising costs have made it very hard for patients to meet their financial obligations. According to a 2006 study by the Harvard School of Public Health, 11% of patients lose their health insurance while undergoing treatment, and a similar number become unable to pay for basic needs like food and shelter. The uninsured are by far the worst off, with more than a third using up all their savings before seeking public assistance, but even those with insurance, especially Medicaid, suffer from extra stress as a result of trying to pay their co-pays or find doctors willing to take their insurance. Even their treatment suffers: 84% of oncologist say that concerns about their patients ability to pay affects their decision about how to treat patients.

Medicaid patients have been especially hard-hit. The New York Times tells the story of a woman who, after spending two years being treated for cancer by her primary care physician, whom she knew well, was forced to seek a new practitioner because he could no longer afford to take patients on Medicaid. 3.3 million more people joined the Medicaid rolls last year, but fewer and fewer doctors are willing to take Medicaid, and those that do are less likely to recommend more effective (but more expensive) treatments. “The use of hormone-suppressing drugs for prostate cancer, for example, fell 14% in just two years after Medicare slashed what it was paying doctors,” says USA Today, based on a study in the medical journal Cancer. We may have better medicine, but who can afford it these days?

Check back next week for Part 2: Personal Stories