Republicans Sens. Tom Coburn (Okla.) and Richard Burr (N.C.) today unveiled a plan to revamp Medicare that would accelerate a transition to private insurance, raise the benefit eligibility age and up the premiums paid by middle-class and upper-income seniors. (Avik Roy calls it “the best Medicare reform proposal yet.”)

Coburn said it best when he explained to The Washington Times why they decided to release the plan in an election year, when it’s unlikely to actually go anywhere: “All of us in Congress are running around fixing everything except our biggest problem. If you don’t start fixing Medicare, you can’t save it.”

Overextended entitlement programs are the key drivers of the national debt, and, of the Big Three, Medicare is most in need of reform. Consider: Medicare, Medicaid and Social Security will consume all tax revenues by 2049, according to The Heritage Foundation’s Budget Chart Book. Medicare spending is adding to future deficits faster than any other program spending.

Yet, politicians continue to avoid the issue. The Senate’s dereliction of duty on a budget matters so much precisely because the appropriations process doesn’t touch entitlements; the yearly budget is the ideal place to take stock of entitlement programs and to make needed adjustments. With no budget in three years, the federal government has operated on autopilot when it comes to entitlements — at a time when it least can afford to do so, as a debt crisis is looming. The Super Committee that grew out of this summer’s debt ceiling showdown also ignored entitlement reform.

Coburn and Burr, then, deserve the respect, praise and attention of their congressional colleagues simply because they had the bravery to bring up an unpopular subject.

They’re not the first to do so, of course; Medicare reform was and is an essential component of Paul Ryan’s Roadmap to Prosperity (although he has subsequently introduced another plan, the Paul-Wyden plan). His Medicare proposal became a key issue in the NY-26 special election, in which Democrat Kathy Hochul defeated Republican Jane Corwin. The election featured what Ryan called “scare tactics, distortions [and] demagoguery” to scare seniors into voting against Medicare reform in the person of Jane Corwin.

The backlash to Ryan’s introduction of his own ideas hasn’t deterred him in the least, however. The Washington Examiner even reports that he’s already working with congenial Democrats to lay a foundation for real reform should Republicans take the White House and Senate in November:

He won’t name names, but House Budget Committee Chairman Paul Ryan, R-Wis., revealed this morning that he’s meeting with Democrats to chart reforms on Medicare and taxes should President Obama get the boot in November and the GOP take over.

Medicare is his top issue and he said the two sides are “planting the seeds to reap a bipartisan solution after this election because we know it’s not going to happen before.” Pressed to dish on the Democrats, he said, “I’m not going to give you any names to protect the innocent.” He explained that they are “not wiling to cross” Obama or House and Senate Democratic leaders before the election.But he described them as moderates interested in pushing reforms aimed at pegging benefits to income, meaning the poor get more than the rich, rather than imposing price controls on services. “We don’t have much time before a crisis hits us,” said Ryan. “You’ve got about two or three years America.”
At this point, any discussion of Medicare reform is better than no discussion. Tangible action will have to wait until after November — but, to borrow a phrase from the president, can’t wait much longer than that or there’ll be no Medicare to reform.