"There are promising signs that federal programs and policies, as well as aggressive private sector activities, have helped to curb cost growth in Medicare and overall health expenditures. However, even if we continue to reduce the growth of health care costs and improve overall value, demographic trends and constrained state and local budgets will drive health and retirement spending toward an even larger share of the economy.... We must make difficult decisions in the coming years to encourage system-wide cost containment and sustainable health care transformation."  MORE >>