The large baby boomer generation is getting old, and thus their costs will go up just by nature of old people needing more. They are also realizing that health is the largest factor in how long they will live (not to mention that they likely started smoking before people realized how harmful it was - most have long quit but with unknown damage done. There are other choices that they often made that are now questionable)

Which is to say I expect spending to go up just for demographic reasons of large numbers of people starting to care. Don't confuse this for thinking all is well with health care costs.