Before the financial crisis hit, the U.S. appeared to be headed towards a fiscal calamity, probably no later than the early 2020s. The likely doomsday date has surely moved several years closer, perhaps to some point in the late 2010s.
I nonetheless accept the need for something like Obama's Economic Recovery Plan, and also agree that this is the time to do healthcare. But even if all this goes well, the really tricky part will be navigating back towards fiscal responsibility, after having opened the federal wallet wide and benefited from doing so.
In a really optimistic scenario, the political credibility rightfully gained in 2009 will create genuine political capital, not Bush 2004-style fool's gold, that can actually be used to do unpopular things that are unlikely to have any Republican support.