The Kaiser Family Foundation released a disturbing yet ultimately unenlightening study on how cancer care costs are undermining family finances. Many employer-sponsored insurance plans have caps that don't cover today's extraordinarily high costs for cancer care; a quarter of cancer patients use up all or most of their savings; cancer survivors who chance jobs or lose coverage are routinely turned down by insurers when they go into the individual market; and state high risk pools, designed to cover such people, offer skimpy coverage or are not available in most states.

"The problem," according to John Seffrin, chief executive officer of the American Cancer Society, "is underinsurance. The lack of access to quality and affordable health care has become a major cancer killer. Two million cancer survivors are foregoing care today because of underinsurance," he said.

Yes, we know all that. But even if the entire population was well insured, the nation would still have to deal with the extraordinarily high and rapidly escalating cost of cancer care. Alas, despite extensive news media coverage over the past year about rising cancer care costs -- largely due to the rapid increase in the price of new cancer drugs -- the study and the Kaiser forum where it was released was largely silent on the cost issue.

Why didn't they invite Peter Bach of Sloan Kettering Cancer Center in New York? Just last week in the New England Journal of Medicine, he pointed out that "with each advance in treatment, the magnitude of the increase in cost of treatment exceeded the magnitude of improvement in efficacy, thus making each treatment advance less cost-effective than the one that preceded it."

The only commentator at the forum to address the cost issue, even if only tangentially, was John Rowe, a former insurance industry executive now at the Columbia University School of Public Health. Treating cancer patients who are in the third and fourth stages of the disease -- which defines the more than half million people who die from cancer every year -- is subject to huge variability, he said. That is especially true now that Medicare covers most experimental regimens after expanding the number of compendia that can be used to justify reimbursement for oncologists who use those experimental regimens.

Kaiser, like most health-oriented foundations in the policy arena, focuses virtually all of its attention on insurance coverage issues. As a result, those concerned about costs get short shrift in the policy debates in the nation's capital. A quick suggestion: Kaiser should begin funding researchers, policy analysts and advocates who focus on cost and how we can get greater value out of the trillions we spend on care. And when they hold forums on insurance issues, they should include them on the panels.