Whenever American Action Forum President Doug Holtz-Eakin testifies before Congressional Committees about healthcare spending, he always emphasizes the need to first create a budget. If the US had a set healthcare budget, policymakers could work within those limits to get the most value possible for our healthcare dollars. Unfortunately, because Medicaid and Medicare are unlimited entitlement programs, and with the Affordable Care Act (ACA) creating a new entitlement program of health insurance subsidies, the limit to healthcare spending is out of sight.