The Congressional Budget Office (CBO) shone a glaring spotlight on the state of the U.S. economy with a report that predicts that the federal budget deficit will reach $1 trillion in 2020 on its way to a deficit of more than $1.5 trillion eight years later. Perhaps even more disturbing for makers of drugs and devices is that Medicare spending has resumed its robust growth rate now that the recession is over, and may double to $1.5 trillion in 2028, roughly the same number as the overall budget deficit in 2028.