Medicare costs need to be controlled

Both Obama and Romney campaigns don't want to tell seniors the ugly truth: Medicare costs have to be reined in. They're not sustainable. And we either need to cut benefits or raise taxes to pay for it or change pretty significantly the way Medicare services are delivered.

We might have to do a little of each.

There's a great explanation on the claims of each campaign and how they're deceptive on Medicare at FactCheck.org. They also give great background on the history of Medicare.

It's not surprising that Congress and the president have raised Medicare payroll taxes several times over the years to help keep the health care benefits flowing to in important voting constituency.

But after reading it, you can't come to any other conclusion that we either need to rein in benefits or raise taxes to pay for care that's costly and inefficient and will eventually consume a greater share of GDP.

But the good news is we know how to cut Medicare costs. We only have to have the courage to do it.

Obama's plan was to reduce payments to health care providers and make them share the pain of cost reductions. Critics argue it might not be enough, and some providers might stop taking Medicare patients. He also planned to cut subsidies to private insurance plans offering Medicare.

Romney and Ryan want to allow more private insurance into serving Medicare patients as well as leaving traditional Medicare in place, figuring competition will drive down costs. But that only works if we have a lot of medical providers competing. And more and more, the health care market is consolidating and getting fewer competitors. Some worry that the private insurers will pick the healthiest seniors and leave the really sick ones for the government to serve through traditional Medicare.

Seniors today and those of the near future, Baby Boomers, have to get realistic about all of this and realize they are not going to be able to go to the doctor for every little ailment and have the government mostly pay for it.

They're going to have to go to a more managed care system, where they learn prevention, where they learn they can see a nurse instead of a doctor.

This is not Medicare as we know it. It has to change.