The global financial crisis and resulting Great Recession accelerated both national and international debate over the sustainability of U.S. government spending. This is the direct consequence of the crisis pushing the U.S. ratio of gross debt to GDP over 90 percent, due both to large increases in government spending and large decreases in tax revenue. (See Figure 1.) The fresh sense of urgency that this has ignited to solve the debt situation, however, obscures the fact that U.S. government spending was no more sustainable prior to the Great Recession than it is now. Put another way, the recent large deficits change almost nothing about the long-term fiscal prospects of the United States. The overwhelming obstacle to a sustainable fiscal path for the United States, regardless of the size of the current debt, remains health-care spending.