The U.S. is headed for a fiscal meltdown. Even before Congress began calling for a hugely expensive overhaul of health care, the federal government was a staggering $56 trillion in the hole, in terms of unfunded obligations.

That's $184,000 of debt for every American.

Even after its tax increases, the House health bill would add an additional $10 trillion in red ink. No wonder foreign investors as well as ordinary Americans are beginning to worry we won't be able to pay our national bills.

But even if Congress rethinks an explosion of new health care debt, we still face the underlying problem of unfunded promises.

That's because more and more baby boomers will start to leave the workplace and start collecting from two social insurance entitlements -- Social Security and Medicare. The nonpartisan Congressional Budget Office estimates that Medicare and Social Security will eat up almost $1 of every $7 generated in America by 2050, double today's proportion.

To deliver the benefits already promised to future seniors, government would gradually have to (a) impose crippling tax hikes, (b) borrow at untenable levels or (c) over time eliminate nearly all other government programs.

None of these options is viable. We need a grand rethinking of social insurance -- a thorough modernization that reflects current economic and fiscal realities.

By "social insurance" we mean universal retirement programs that are funded -- though not completely -- by payroll taxes. Retiring baby boomers will collect far more in Social Security or Medicare benefits than they ever paid in payroll taxes. That's a good deal for them, but it means their children and grandchildren will be stuck with the tab.

We can't "tweak" our way out of this with a tax hike here or a benefit squeeze there. We, instead, have to rethink these social insurance programs by balancing personal responsibility with economic protections and reducing debt. And we need to weigh how much we spend on these programs against other national needs and priorities. That way, we can control the size of government and better protect the less fortunate.

A revamped approach to retirement security that reduces debt would have three tiers.

The first tier is personal savings. Those who aren't poor should be expected to save for predictable events, such as a basic income and routine health care costs during retirement. But most Americans suffer from inertia and don't get around to saving systematically. That's why it's a good idea for employers automatically to enroll their workers in retirement savings plans. You could opt out, but under the default you would be enrolled. Bipartisan legislation on Capitol Hill, with President Obama's blessing, would help firms set up such "auto-enrollment" savings plans.

Second, we should make "real" insurance, not social insurance, the first resort for dealing with events such as catastrophic medical expenses, disability, long-term care and unemployment. Individuals who can afford to carry reasonable levels of insurance should do so, rather than expect "society" to cover for them.

Traditional social insurance programs such as Medicare and Social Security should be the final tier. But they need to be scaled back and reserved for those who truly need them. Adjusting benefits according to economic status is the fairest, most rational way to ensure economic security without committing fiscal hara-kiri.

To build political pressure to get the big social insurance programs under control, we'll also need to end their preferential treatment in the budget process. While other programs must compete for funding and live within their budgets, this spending is on "autopilot" - that's why programs such as Medicare and Social Security are called "entitlements."

We should fix that by turning entitlements into 30-year "discretionary" programs, with real, legislated budgets and automatic changes in benefits to keep them on track. These budgets should be reviewed and reauthorized regularly -- say, every five years -- to reflect changing needs and priorities.

Rethinking social insurance programs in this way would produce a more progressive approach to aiding the needy, a better balance between social obligation and individual responsibility, and a sensible budget process that reflects our national priorities and American values.

It would provide real economic security to today's aging baby boomers while starting to reduce the staggering debt we are currently passing on to our children and grandchildren.

Stuart M. Butler, Ph.D., is Vice President for Domestic and Economic Policy Studies at The Heritage Foundation.