If current budgetary trends persist, sometime between 2016 and 2020 existing federal revenues will cover only health entitlements, Social Security, debt service, and a smaller defense budget, leaving nothing for anything else. The researchers warn that budget-driven reforms in health policy must aim to end automatic year-to-year budget growth and push Congress to formally recognize when it chooses health cost increases over other priorities. Rather than get derailed on the search for one grand reform, they suggest a host of reforms that would empower government, provider, insurer, and citizens alike to choose a better and more efficient health delivery system. Health Affairs_ 27(3):633-644 (May/June 2008).