I think the best we could hope for is for it to level off and go back to as a country living within our means. To get somewhere near a balanced budget. 

I give that about one in ten thousand chance. Nobody will vote for anyone who promotes austerity. And that is what it would take when the freebee programs go away. The medical monopoly is the elephant in the room. Everybody wants "free" healthcare and nobody wants to pay for it.