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The Monster At Our Door; Uncontrolled health spending poses ugly choices: raise taxes, gut other programs or run ever-larger and dangerous deficits.

Byline: Robert J. Samuelson

Unless you're a news junkie, you probably missed Mark McClellan's announcement that he'll resign in early October, after two grueling years as head of CMS. What's CMS? Well, it's the Centers for Medicare and Medicaid Services, which spent $515 billion in 2005--21 percent of the federal budget and about $21 billion more than all defense spending. Leaving government presents McClellan with a golden opportunity: he can tell us what to do about Medicare. It's the monster in our future--and no one knows it better than McClellan, who is a medical doctor, a Ph.D. economist and since 2004 Medicare's chief bureaucrat. Moreover, he's not a rabid ...

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