The government debt is a concern, and debt/GDP ratio puts it in proportion.
Here are some points
1. The USA debt to GDP ratio is 0.9, and the Japan debt to GDP ratio is 2.2.
2. Japan has a quite robust economy, albeit with concerns about an aging population.
3. The USA with a deficit of 1.3T$/yr it will take 10 years to reach Japan's debt to GDP ratio.
4. Often the ratio is associated with "unfunded liability" (aka medicare, social security, medicaid, which tolal about 50T$) and is an entirely different debt (we don't pay principal or interest on it now).
5. Technology may provide dramatic reductions in health care costs (self administered tests, monitoring, eMedical visits, etc. Health care is information based and information is becoming dramatically less costly )
6. Inflation, or even hyper inflation, is forecast because of the increasing debt. Inflation can pay off the debt with cheap (inflated) dollars. If the debt "rolls over' in 2,5,10 year US treasury bonds for 10 years, then the bond holders would see their bonds value reduced to .81, .60, and .35 of their original value, assuming a 10% inflation rate (1 - 0.10)^10=.35). If 1/3 of the total debt were for each kind of bond, then the USA debt of 13T$ would be 13T$ / 3 * ( .81 + .60 + .35) = 7.6T$, or about half after 10 years.
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