1. Chronic Deficit: Entitlement Crisis? or Health Financing Problem? or Health Financing Problem? Henry J. Aaron Bruce and Virginia MacLaury Senior Fellow The Brookings Institution

2. A “monster at the door.” Robert Samuelson The prevailing ‘expert’ view A fiscal cancer, “massive entitlement programs we can no longer afford, exacerbated by a demographic glitch that began more than 60 years ago David Walker “...a government in desperate trouble. It’s raising taxes sky high, drastically cutting retirement and health benefits, slashing defense, education, and other critical spending, and borrowing far beyond its capacity to repay.” Laurence Kotlikoff and Scott Burns

3. What Projections Really Show (1)

4. What Projections Really Show (2)

5. …the fiscal problem is entirely a health care financing problem The message… …since taxes are assumed to remain a constant share of GDP, projections show no other long-term budget problem …because public and private health care spending move together, there is also a private health care financing problem

9.  The morals of this story…  The morals of this story… all 1.There is a long term fiscal problem; all of it is health care 5.There is no practical way to deal with public health care spending other than by general health care financing reform 3. There is an equally urgent private budget problem also stemming from increasing health care spending 4. These problems are important for three reasons: fiscal balance, consumption growth, and health care access and affordability 2. There is no entitlement crisis other than health care