CBO Director Peter Orszag editorializes in the Wall Street Journal today on long-term budget problems. It's a great piece. Key excerpts: The bottom line is that while we need to address the effects of the coming retirement of the baby boomers and the projected imbalance in Social Security, we have to pay even more attention to the health-care costs that exert the dominant influence on our fiscal future. Policy makers will face both challenges and opportunities in trying to reduce these costs... But it's too soon to conclude that the fiscal picture is hopelessly dismal. There remains the promising possibility of restraining health-care costs without incurring adverse health consequences. It may even be possible in some cases to reduce cost growth and improve health at the same time. Costs per beneficiary in Medicare, for example, vary substantially across the U.S. for reasons that cannot be explained fully by the characteristics of the patients or price levels in different areas. One thing to look out for is whether congressional leaders or the presidential candidates listen to Orszag. Getting this message in the media seems like a good first step and the best way to challenge the dominant take on the issue, which is epitomized by wretch-inducing Robert Samuelson columns.