President Obama made clear in his State of the Union address Tuesday that healthcare costs are the biggest driver of U.S. debt, but offered no new proposals for reining in those costs. "Those of us who care deeply about programs like Medicare must embrace the need for modest reforms—otherwise, our retirement programs will crowd out the investments we need for our children, and jeopardize the promise of a secure retirement for future generations," Obama said. His proposals to reduce entitlement spending hewed to ideas he has already proposed in all or nearly all of his budget proposals as president.