I'm on holiday midazolam 40 mg The wild card is health care costs, both public and private, which historically have grown faster than GDP for various reasons, including technological advances and more utilization. CBPP projects, based on projections by the Social Security and Medicare Trustees and CBO, that the Obamacare cost-controls plus other developments in health care delivery will slow but not erase the "excess cost growth" in U.S. health spending. Different assumptions about health care cost growth are one key feature distinguishing CBPP's optimistic and pessimistic projections from its base case.