CBO Director Peter Orszag cuts to the chase: healthcare is the overriding issue:
The United States faces serious long-run budgetary challenges. If action is not taken to curb the projected growth of budget deficits in coming decades, the economy will eventually suffer serious damage. The issue facing policymakers is not whether to address rising deficits, but when and how to address them. At some point, policymakers will have to increase taxes, reduce spending, or both. Much of the pressure on the budget stems from the fast growth of federal costs on health care. So constraining that growth seems a key component of reducing deficits over the next several decades. A variety of evidence suggests that opportunities exist to constrain health care costs both in the public programs and in the health care system overall without adverse health consequences.Fixing healthcare is clearly the answer to Mark Thoma's question about what you would do with one wish. A close runner-up would be wholesale adoption of school vouchers. Well, maybe not wholesale adoption of school vouchers, but some sort of market-based overhaul of the public education system. No other issue even comes close to healthcare and education in terms of overall importance.