Some doctors have made a scary discovery: by 2035, the average family could face medical costs exceeding their total income.

The study, published in the Annals of Family Medicine, projected the typical spending on insurance premiums and out-of-pocket expenses, and compared it with the growth of income and inflation to come up with the frightening prediction.

But it wasn’t entirely unexpected. Since the government began to track health care costs in the 1960s, they’ve grown at a sometimes alarming rate. Researchers say between 2000 and 2009, insurance premiums went up an average rate of eight percent, while household income rose only 2.1 percent.

Although some analysts say the 20-year projection is overly pessimistic, paper co-author Dr. Jennifer DeVoe of the Oregon Health Sciences University in Portland already sees the impact of rising costs in her practice.

“I see people who don’t eat, or don’t pay rent, so they can pay medical bills,” she says. “They can’t afford their medication, or in some cases, even a mammogram.”

[CNN]