Health care costs clobbered Peggy Tate and sent her to economic purgatory after her husband died of cancer five years ago.

The 51-year-old Scappoose woman took out a second mortgage to pay $30,000 in costs not covered by her husband's insurance. She also has monthly payments for diabetes medicine, her son's medical needs, state-subsidized health insurance and more than $10,000 of medical debt on credit cards. Altogether, medical bills eat about 40 percent of the $2,500 a month she earns running a home day-care business....

Rising health care costs hit Tate harder than most, but a growing portion of Oregon's middle class also is seeing health care carve into household budgets...

The United States spends more than twice as much per person on health as the average industrial nation. Yet the World Health Organization ranked the U.S. 37th in the world in overall health care, based on life expectancy, infant mortality and spending on chronic illnesses.

"That puts us right between Slovenia and Costa Rica -- countries that should beat us in soccer but not at health care," says Len Nichols, a health economist and director of health policy at the New America Foundation, a bipartisan think tank in Washington.

"We have way too many people getting MRIs and CAT scans," Nichols says. "And too much surgery..."

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