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 <subject>Federal social security programs</subject>
 <subject>Medicare</subject>
 <subject>Social security benefits</subject>
 <subject>Fiscal policies</subject>
 <subject>Budget deficit</subject>
 <subject>Cost analysis</subject>
 <subject>Health care cost control</subject>
 <subject>Federal debt</subject>
 <subject>Health care costs</subject>
 <subject>Health care reform</subject>
 <subject>Future budget projections</subject>
 <subject>Economic growth</subject>
 <subject>Intergovernmental fiscal relations</subject>
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 <title>Long-Term Fiscal Outlook: Long-Term Federal Fiscal Challenge Driven Primarily by Health Care</title>
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<abstract>GAO was asked to provide its views on the long-term fiscal
outlook. This statement addresses four key points: (1) the	 
federal government&apos;s long-term fiscal outlook is a matter of	 
utmost concern; (2) this challenge is driven primarily by health 
care cost growth; (3) reform of health care is essential but	 
other areas also need attention which requires a multipronged	 
solution; and (4) the federal government faces increasing	 
pressures yet a shrinking window of opportunity for phasing in	 
needed adjustments. GAO&apos;s simulations of the federal government&apos;s
long-term fiscal outlook were updated with the Trustees 2008	 
intermediate projections and continue to indicate that the	 
long-term outlook is unsustainable. This update combined with	 
GAO&apos;s analysis of the fiscal outlook of state and local 	 
governments demonstrates that the fiscal challenges facing all	 
levels of government are linked and should be considered in a	 
strategic and integrated manner. Since 1992, GAO has published	 
long-term fiscal simulations of what might happen to federal	 
deficits and debt levels under varying policy assumptions. GAO	 
developed its long-term model in response to a bipartisan request
from Members of Congress who were concerned about the longterm	 
effects of fiscal policy. Information about GAO&apos;s model and	 
assumptions can be found at					 
http://www.gao.gov/special.pubs/longterm/.</abstract>
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<identifier type="preferred citation">GAO-08-912T</identifier>
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<note>Testimony</note>
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 <topic>Federal social security programs</topic>
 <topic>Medicare</topic>
 <topic>Social security benefits</topic>
 <topic>Fiscal policies</topic>
 <topic>Budget deficit</topic>
 <topic>Cost analysis</topic>
 <topic>Health care cost control</topic>
 <topic>Federal debt</topic>
 <topic>Health care costs</topic>
 <topic>Health care reform</topic>
 <topic>Future budget projections</topic>
 <topic>Economic growth</topic>
 <topic>Intergovernmental fiscal relations</topic>
 <topic>Federal/state relations</topic>
 <topic>Comparative analysis</topic>
 <topic>Data integrity</topic>
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