As we like to say here at Beat the Press, the long-term deficit problem is primarily health care, health care, and health care. Robert Samuelson gets this one 100 percent right in his column today.
He concludes that the way to contain costs is some sort of voucher system or a single-payer type universal Medicare program. It's questionable whether a voucher system will actually contain costs, as opposed to reduce the quality of care (unless it involves buy-ins to other countries' systems), but this is the direction the budget debate should take. The question is how we deal with health care costs; it is not a problem of an out of control budget more generally.