Half of government spending could be taken up by health and social care in 50 years time, one influential think tank said today.
Changes to the population and medical advances will increase pressure to spend more on health and social care in the future, The King's Fund report said.
However, the report stressed that these increases are not inevitable
Chief economist at The King's Fund and author of the report John Appleby said: "It's time to think much more long term about how much we should spend, the benefits of this spending and how it should be paid for.
"By turning the spotlight on these issues now, we hope to stimulate an informed debate about the difficult choices ahead."
Close to 9% of national spending is on health and social care, more than double what it was 50 years ago.
According to forecasts by the Office for Budget Responsibility, this could more than double again by 2061.
The report calls for a public debate about these choices, and recommends that regular reviews of spending pressures should be commissioned.
The King's Fund claim that age will factor less in the increase in spending than previously believed.
"The health care needs of the country are becoming more complex and the NHS needs to adapt to these changes while maintaining its core principles," said Royal College of Nursing chief executive and general Secretary Dr Peter Carter.
"We hope this report encourages a longer-term approach to workforce planning to ensure that there is the right number of staff and sufficient resources to effectively deal with patients' needs."