There is definitely a plethora of reasons that are leading to such a significant rise in costs.  There is definitely an increasing number of people who are living longer and therefore the number of elderly is increasing.  Along with the being older and living longer, there is the possibility of more prolonged time period for chronic diseases, nursing homes, and other long-term health care needs which are causing costs to rise because of everything from medications to hospital care.  At the same time, as the older population increases, there may not be enough of the younger population or "active working" population to offset the costs caused by the increase of an ever increasing older population.

More costs is definitely harder on people because of bad economic times, but at the same time more and more people are signing up for government programs for care...which has its own set of issues as more people sign up for it, but the tax dollars for the programs are coming from working tax payers...

Since many of the chronic diseases and preventable diseases such as heart disease & diabetes are the ones that are prominent in morbidity now a days, we should definitely put more money into preventive medicine.  The problem is the government wants to see immediate results, the people want to see immediate results and we all know that doesnt happen in preventive medicine.  Unfortunately this ends up in a situation, where the best solution wont get the needed $$ because the solution does not appear to be the solution, because it's not immediate.