Much of the recent health care reform debate has focused on achieving budget neutrality over a 10-year period, but this goal is less important than the reform's long-run fiscal sustainability. If the rate of growth of health care spending continues to exceed the rate of income growth by its historical margin of more than 2 percentage points, the consequences for beneficiaries, federal and state budgets, and the entire economy — given the implied increase in tax rates and forgone consumption — will be dire.
Chernew, Michael E., Lindsay M. Sabik, Amitabh Chandra, and Joseph P. Newhouse. "Ensuring the Fiscal Sustainability of Health Care Reform." New England Journal of Medicine 362.1 (January 7, 2010): 1-3.