The United States has had a public debt since its founding in 1791. Debts incurred during the American Revolutionary War and under the Articles of Confederation amounted to $75,463,476.52 on January 1, 1791. From 1796 to 1811 there were 14 budget surpluses and 2 deficits. There was a sharp increase in the debt as a result of the War of 1812. In the 20 years following that war, there were 18 surpluses and the US paid off 99.97% of its then debt. Another sharp increase in the debt occurred as a result of the Civil War. The debt was just $65 million in 1860, but passed $1 billion in 1863 and reached $2.7 billion by the end of the war. During the following 47 years, there were 36 surpluses and 11 deficits. During this period 55% of the national debt was paid off. The next period of major increase in the national debt took place during World War I, reaching $25.5 billion at its conclusion. It was followed by 11 consecutive surpluses and saw the debt reduced by 36%.

Social programs enacted during the Great Depression and the buildup and involvement in World War II during the F.D. Roosevelt and Truman presidencies in the 1930s and 1940s caused the largest increase a sixteenfold increase in the gross public debt from $16 billion in 1930 to $260 billion in 1950. When Roosevelt took office in 1933, the national debt was almost $20 billion; a sum equal to 20 percent of the U.S. gross domestic product (GDP). During its first term, the Roosevelt administration ran large annual deficits between 2 and 5 percent of GDP. By 1936, the national debt had increased to $33.7 billion or approximately 40 percent of GDP. Gross debt relative to GDP rose to over 100% of GDP to pay for the mobilization before and during World War II.

After World War II
The debt burden fell rapidly after the end of World War II, as the US and the rest of the world experienced a post-war economic expansion. However, growth rates in the western countries began to slow in the mid-1960's. Beginning in the mid-1970s and afterwards, U.S. government debt began to increase faster than GDP. Debt relative to GDP rose rapidly during the 1980s under president Ronald Reagan, whose economic policies increased military spending and lowered tax rates. Gross debt in nominal dollars quadrupled during the Reagan and Bush presidencies from 1980 to 1992. The net public debt quintupled in nominal terms. Debt held by the public had declined from 28% to 26% of GDP in the 1970s, by contrast, it rose to 41% of GDP by the end of the 1980s. During the 1990s, debt held by the public had risen to nearly 50% of GDP in the early 1990s, but fell to 39% of GDP by the end of the decade. The public debt burden fell during the presidency of Bill Clinton between 1992 and 2000, due in part to tax increases under the Deficit Reduction Act of 1993, increased tax revenue resulting from the Dot-com bubble and Social Security payroll taxes. The budget controls instituted in the 1990s successfully restrained fiscal action by the Congress and the President and together with economic growth contributed to the budget surpluses that materialized by the end of the decade. These surpluses led to a decline in the debt held by the public, and from fiscal years 1998 through 2001, the debt-to-GDP measure declined from about 43 percent to about 33 percent. Debt relative to GDP rose due to recessions and policy decisions in the early 21st century. From 2000 to 2008 debt held by the public rose from 35% to 40%, and to 62% by the end of fiscal year 2010. During the presidency of George W. Bush, the gross public debt increased from $5.7 trillion in January 2001 to $10.7 trillion by December 2008, due in part to the Bush tax cuts and increased military spending caused by the wars in the Middle East. Under President Barack Obama, the debt increased from $10.7 trillion in 2008 to $14.2 trillion by February 2011, caused mainly by decreased tax revenue due to the late-2000s recession.

Rick Santorum had a heated exchange with a mother and her sick young son Wednesday, arguing that drug companies were entitled to charge whatever the market demanded for life-saving therapies.

Santorum, himself the father of a child with a rare genetic disorder, compared buying drugs to buying an iPad, and said demand would determine the cost of medical therapies.

"People have no problem paying $900 for an iPad," Santorum said, "but paying $900 for a drug they have a problem with - it keeps you alive. Why? Because you've been conditioned to think health care is something you can get without having to pay for it."

The mother said the boy was on the drug Abilify, used to treat schizophrenia, and that, on paper, its costs would exceed $1 million each year.

Santorum said drugs take years to develop and cost millions of dollars to produce, and manufacturers need to turn a profit or they would stop developing new drugs.

"You have that drug, and maybe you're alive today because people have a profit motive to make that drug," Santorum said. "There are many people sick today who, 10 years from now, are going to be alive because of some drug invented in the next 10 years. If we say: 'You drug companies are greedy and bad, you can't make a return on your money,' then we will freeze innovation."

Santorum told a large Tea Party crowd here that he sympathized with the boy's case, but he also believed in the marketplace.

"He's alive today because drug companies provide care," Santorum said. "And if they didn't think they could make money providing that drug, that drug wouldn't be here. I sympathize with these compassionate cases. ... I want your son to stay alive on much-needed drugs. Fact is, we need companies to have incentives to make drugs. If they don't have incentives, they won't make those drugs. We either believe in markets or we don't."