Eft ventricular assist device (LVAD) at a cost of 200,000. It is estimated that we could implant 200,000 of these devices annually. We also have in clinical testing a totally implantable artificial heart. It is estimated that we could install 350,000 of these devices annually when clinically available at a cost of 300,000 each. This is all in one area of medicine, not to mention all the new cardiology drugs or other cardiac procedures. This same story will be replicated in virtually every other area of medicine, including oncology. In oncology policy attention has been focused on these extraordinarily expensive targeted therapies. There are more than sixty of these drugs now with course of treatment prices ranging from 50,000 to more than 130,000. About 580,000 Americans die of cancer annually and 1.66 million are newly diagnosed annually [23]. In 2012 there were 13.7 million Americans identified as cancer survivors [23]. More than 3 million Americans will be actively treated for their cancer in any given year. In 2010 the total cost of medical care for cancer patients in the US was about 125 billion [23]. Assuming a 5 annual increase in costs for cancer care in the US (which is very conservative, depending upon what assumptions are made regarding access to these targeted therapies), those costs will rise to 207 billion in 2020 (constant 2010 ). In that year it is projected there would be 18 million American cancer survivors. In 2020 projected aggregate health costs in the US are placed at 4.5 trillion, roughly 20 of anticipated GDP [20]. Noteworthy is the fact that cancer is most often a disease of the BQ-123 site elderly, those over age 65. About two-thirds of cancer patients are over age 65. In the US this is especially significant because these are costs that are largely borne by the Medicare program, mostly funded by taxes. In 2012 the Medicare program spent about 600 billion for 47 million covered lives [20]. This program is projected to cost the federal government 1 trillion in 2020 [20], and 8.5 trillion over the ten-year Abamectin B1aMedChemExpress Avermectin B1a period from 2013 to 2022. Driving these costs upward are the technological developments discussed above and the aging out of the post WW II baby boom generation, expected to swell the Medicare population to 80 million by 2030. Again, this aging out of the population implies dramatic increases in the incidence of cancer and equally dramatic increases in the cost of treating those patients, especially if these targetedJ. Pers. Med. 2013,therapies become very widely disseminated. Younger cancer patients will often struggle with paying for needed cancer treatments due to being uninsured or underinsured, and consequently, will often be denied access to these treatments by hospitals and physicians. But Medicare is often described as national health insurance for the elderly. It is an entitlement program that assures access to these treatments for the vast majority of Medicare patients with cancer. Though all the statistics presented thus far are related to the US, comparable statistics can be generated for the European Union. The nations of Europe are generally spending smaller fractions of their GDP on health care, mostly in the range of 8 to 12 . Still, the problem of health care cost control is judged to be as socially and politically problematic in the European Union as in the US. The EU is faced with an aging population comparable to the US. Costly new medical technologies, including all these targeted cancer d.Eft ventricular assist device (LVAD) at a cost of 200,000. It is estimated that we could implant 200,000 of these devices annually. We also have in clinical testing a totally implantable artificial heart. It is estimated that we could install 350,000 of these devices annually when clinically available at a cost of 300,000 each. This is all in one area of medicine, not to mention all the new cardiology drugs or other cardiac procedures. This same story will be replicated in virtually every other area of medicine, including oncology. In oncology policy attention has been focused on these extraordinarily expensive targeted therapies. There are more than sixty of these drugs now with course of treatment prices ranging from 50,000 to more than 130,000. About 580,000 Americans die of cancer annually and 1.66 million are newly diagnosed annually [23]. In 2012 there were 13.7 million Americans identified as cancer survivors [23]. More than 3 million Americans will be actively treated for their cancer in any given year. In 2010 the total cost of medical care for cancer patients in the US was about 125 billion [23]. Assuming a 5 annual increase in costs for cancer care in the US (which is very conservative, depending upon what assumptions are made regarding access to these targeted therapies), those costs will rise to 207 billion in 2020 (constant 2010 ). In that year it is projected there would be 18 million American cancer survivors. In 2020 projected aggregate health costs in the US are placed at 4.5 trillion, roughly 20 of anticipated GDP [20]. Noteworthy is the fact that cancer is most often a disease of the elderly, those over age 65. About two-thirds of cancer patients are over age 65. In the US this is especially significant because these are costs that are largely borne by the Medicare program, mostly funded by taxes. In 2012 the Medicare program spent about 600 billion for 47 million covered lives [20]. This program is projected to cost the federal government 1 trillion in 2020 [20], and 8.5 trillion over the ten-year period from 2013 to 2022. Driving these costs upward are the technological developments discussed above and the aging out of the post WW II baby boom generation, expected to swell the Medicare population to 80 million by 2030. Again, this aging out of the population implies dramatic increases in the incidence of cancer and equally dramatic increases in the cost of treating those patients, especially if these targetedJ. Pers. Med. 2013,therapies become very widely disseminated. Younger cancer patients will often struggle with paying for needed cancer treatments due to being uninsured or underinsured, and consequently, will often be denied access to these treatments by hospitals and physicians. But Medicare is often described as national health insurance for the elderly. It is an entitlement program that assures access to these treatments for the vast majority of Medicare patients with cancer. Though all the statistics presented thus far are related to the US, comparable statistics can be generated for the European Union. The nations of Europe are generally spending smaller fractions of their GDP on health care, mostly in the range of 8 to 12 . Still, the problem of health care cost control is judged to be as socially and politically problematic in the European Union as in the US. The EU is faced with an aging population comparable to the US. Costly new medical technologies, including all these targeted cancer d.