It is expected to increase to $4.4 trillion in 2008. Based on all projections, however, there is an expectation of high enrollment and growth in Medicaid and Medicare spending over that time. (Sisko, Truffer, Smith, 2009). Physician Medicare payments will remain constant between 2010 and 2018. Under the current law, there is an expected acceleration of national healthcare spending starting in 2011 will increase by 7.2% by 2018.By payer Medicare spending is projected to increase by 8.1%, Medicaid by 6.9% and private health insurance by 5.8%. Out of pocket expenses are projected to grow by 3.8% and prescription drugs are expected to increase by 3.5%. Hospital spending is expected to increase by 7.2% and physician services by 6.2%.As we all become greatly concerned over numbers like these, Stuart Altman (2003), tells us that in his opinion, higher spending growth rates are not necessarily destructive. The laws that higher costs are usually offset by lower wages for workers who enroll in employer-sponsored health plans. He does admit that higher costs in public programs are somewhat different because increased spending means increased taxes which then distorts the economy. Higher costs also increase the ranks of the uninsured (Altman, Tompkins, Ellat, 2003). Henry Aaron (2003) agrees with him that he feels that the GDP could be 20% without causing reduced expansion in other parts of the economy.There are, of course, many good reasons for healthcare spending. Some of those are technology but most of them are the overall health and happiness of the people of the United States. Keeping people healthy is important in the sense that they are more productive and happier when they are healthy. There are many issues that need to be death with at this time including obesity, smoking, teen pregnancies and many others.