This question has options. Answer the question about text:

I spend so much of my monthly income on doctors and medications that I am squeezed out of my other bills . I spend more on medications each month than I do on my mortgage . I keep looking at my medications and wondering which ones I can do without . One of the reasons I decided to wait to deal with the oncologists until December is because I can take a breather from the excess bills .

What factor is the cause of this person 's medical bills being so ridiculously high ?
Options:
[I] They are very ineffective at controlling the rate at which they spend money , and do n't save for medication.
[II] None of the above choices ..
[III] They have a bad habit of spending beyond their means and as a result struggle to pay for the essentials.
[IV] The healthcare system in their country requires an absurd amount to be paid out of pocket , and they are a victim of this.
[IV]