From NEJM: Hard choices indeed

http://www.ncbi.nlm.nih.gov/pubmed/21506734

N Engl J Med. 2011 Apr 20. [Epub ahead of print]
Hard Choices - Alternatives for Reining in Medicare and Medicaid Spending.
Rosenthal MB.
Source
From the Department of Health Policy and Management, Harvard School of Public Health, Boston.
Abstract
The U.S. national debt looms like a black cloud on the horizon, and Medicare and Medicaid, which account for about 20% of the federal budget, are responsible for a disproportionate share of projected growth in federal spending. During the past several months, the debate over how to control this growth has intensified, and alternative blueprints for reform have emerged.(1),(2) The two most prominent proposals have been put forward by Congressman Paul Ryan (R-WI), chair of the House Budget Committee, and the White House (see table). Medicare and Medicaid must be key to any deficit-reduction plan, since their growth outpaces . . .