"Forecasts about likely future conditions often are hard to make. But we can be sure of one thing. Health care costs are going to soar in the coming decades as the baby boom generation continues to age and demands an array of increasingly expensive medical services. From 2008 through 2013, U.S. health care spending grew by less than 4 percent annually, one of the lowest rates in more than fifty years. It supplied some modest relief from an unrelenting upward spiral in costs until that time. In 2014, the rate increased somewhat from these levels, rising to 5.3 percent, following a 2.9 percent rise in 2013, largely because of expanded coverage under the then new Affordable Care Act. The following few years saw further, although historically moderate, increases. Nonetheless, total health care spending rose to a record high of $4.1 trillion in 2020, or almost 19.7 percent of the nation's gross domestic product (GDP). The United States spent $12,530 per person for health care in 2020, a figure certain to grow substantially over the next decade. Indeed, the Centers for Medicare and Medicaid Services projects that per capita spending on health care by 2030 will be an astonishing $19,294 and that overall health care spending will rise to $6.75 trillion. These spending figures were released in 2022, more than twelve years after President Barack Obama succeeded in gaining approval from Congress for his sweeping changes in health care policy, the Patient Protection and Affordable Care Act of 2010, also known as Obamacare. One purpose of the act was to slow the rate of increase in the nation's health care spending. Whatever effects the complex, far-reaching, and now broadly supported act may have going forward, we are still likely to see an ongoing rise in national health care costs. What is the best way to deal with these ballooning costs, particularly in light of other trends-for example, continuing elevated levels of obesity-that could drive up costs even further? How should we protect the solvency of the Medicare trust fund as demands from baby boomers threaten to bankrupt it and jeopardize benefits for future generations? Indeed, what forms of health care and Social Security will be available to the generation of citizens now in their teens and twenties? What are the alternatives from which we must choose, and on what basis should we decide?"--