You can certainly look at it as a spending problem. Indeed it is. What is the solution? Stop spending as much. That is as far as the analysis of this problem goes for most conservative pundits, and this thread.
If you look at graphs on historical and predicted spending it is rising much much faster in Medicare/Medicaid than anything else. So in that sense it is both a spending problem and a health care problem. Paul Ryan has a graph on page 50 at the site,
http://paulryan.house.gov/uploadedfiles/pathtoprosperity2013.pdf
While Soc Sec, discretionary spending, and other programs are dropping or will level off, Medicare is "on an "unsustainable path."
So in that sense, Obama had a point, and the quote “We don’t have a spending problem,” is taken out of context and should be followed with Obama's qualifier, "we have a health care problem."
Ryan recognizes that you can't completely take away government medical programs and has a couple of paragraphs titled "Rationing Medicare", but does not go into much detail.
Realistically you should start talking about how to cut medical spending. For me, Medicare has been a godsend. You can only take away my Medicare over my dead body, which I suppose is literally true. And it will be literally true with Medicaid for all the others living near and below poverty level.
