REFORMS ONLY WAY TO SAVE MEDICARE FROM BANKRUPTCY

In the titanic budget struggle looming this fall in Washington, D.C., it is the Big Enchilada, the one battle that will dwarf all others, or, in House Speaker Newt Gingrich phrase, "the toughest fight." It is Medicare.

Along with its entitlement twin, Social Security, Medicare has long been called one of the "third rails" of American politics. (Consider: The very use of the word "entitlement" says something about democratic governance and the propensity of citizens to vote themselves benefits from the public treasury.) Touch that rail, conventional wisdom says, and your fate will be instantaneous electrocution, or at least the political equivalent thereof. Accordingly, politicians have rarely approached it even for discussion, much less serious reform efforts.

This powerful political instinct has its origins in the natural survival impulse common to all animals, perhaps especially political ones. And now this powerful instinct meets up with an irresistible force: the cold, undisputed fact, certified by the Medicare trustees, that if current spending continues, the Medicare trust fund is going broke and will be bankrupt in 2002 -- just seven years off. Among Medicare trustees signing the trustees' report about the program's financial condition are Clinton Cabinet members Robert Rubin (Treasury), Donna Shalala (Health and Human Services) and Robert Reich (Labor).

It could be a brutal collision. Again, conventional wisdom dictates that Republican plans to touch this third rail will prove fatal to their entire, sweeping reform vision set in motion by last November's stunning election results and largely proceeding apace through the first nine months of the year.

A funny thing happened, however, on the way to the Republican funeral over reforming Medicare: the American people were listening to the debate. Considering the two sides, they heard Democrats fall back on time-honored demagoguery, fear-mongering and scare tactics designed to whip up anger among seniors. The Democrat/labor coalition threw several million dollars in TV ads at the GOP in August and will do much more over the next three weeks. For once, however, congressional Republicans had their own act together and proved more than ready with a response in the form of the facts about Medicare's perilous condition, together with imaginative reforms proposals that were still taking shape this week.

As majority Republicans in Congress prepare to act to save Medicare, it helps that they aren't cutting benefits in the first place. In fact, GOP plans call for a reduction in the rate of growth of projected Medicare spending -- not outright cuts. Under the proposed Republican plan to save Medicare, spending will still increase at approximately 5 percent each year.

Another key feature of the GOP plan is a provision for affluent elderly to pay more. To this reasonable proposal, Americans can ask, "Why shouldn't they do so?" It is true that premiums will go up for all recipients, but this seems necessary to save the program. If the alternative is bankruptcy, unpleasant reforms are in order. Anyway, besides lots of overheated rhetoric, what is the Democratic plan to save a Medicare program that all agree is headed over the cliff?

Congressional Republicans say their plan will actually improve choices for seniors and save them from the increasingly bureaucratic, government-run rationing scheme that Medicare has become. Given their seriousness in addressing this crucial issue, Americans should give them some benefit of the doubt as the debate unfolds this fall.