Andrew Biggs puts our fiscal problems in perspective:
Big government isn’t generated by caring for the truly poor; after all, despite spending 25 times more than needed to fill the poverty gap, we nevertheless leave millions in poverty. Rather, rising pension and health spending on middle- and upper-class Americansprincipally through the Social Security, Medicare, and Medicaid programsis the true fiscal burden and the largest imposition on personal choice and freedom. Without these three programs, the current size of government would be much smaller and the dangers of future fiscal catastrophe due to rising spending and debt would be all but eliminated.
Via Reihan, who relates the passage to DC's mayoral race.