The United States is experiencing a spending problem and a health care problem, according to the Cato Institute's new "Handbook on Affordability". The federal government continues to run large deficits, posing a structural threat to price stability. The inflation surge of 2021 was the result of a flood of deficit-financed spending without commitment to repaying it, leading to higher future taxes, deeper spending cuts, or inflation that erases the real value of what the government owes. The problem is deeper as deficits are not evenly distributed across the budget, driven by programs like Social Security and Medicare. The United States spends nearly 18.5% of national income on health care, more than any nation on earth and double the average of other wealthy OECD democracies. The standard political response to the problem is to propose more government subsidies to help patients cover costs, but this is backward. The authors suggest that subsidies are the primary cause of health care unaffordability, which prevents patients from feeling the cost of care. They also suggest that supply-side liberalization and elimination of federal health-insurance regulations could significantly reduce premiums.