As a prelude to analyzing the options for meeting the increasing demands on Medicare, this paper establishes some basic projections about the outlook for Medicare's beneficiaries over the next 25 years. The model described here starts with estimates of the overall Medicare program provided in the annual trustees' report on Medicare. These estimates serve as the basis for further projections of beneficiary burdens that arise from Medicare and from overall acute health care spending. Also briefly described is an alternative set of baseline numbers. The projections represent a serious attempt to examine how health care spending will look through the first quarter of the next century.