The reason is Politics 101 – if taking on Social Security is dangerous, grappling with Medicare can represent a political death wish. “The reason you don’t hear much discussion about it is that it’s quite clear that the president and his allies in the Democratic Party view it as an instrument by which they can bludgeon the Republicans,” said James Capretta, a former OMB official who is now a fellow at the conservative Ethics and Public Policy Center. “People are trying to navigate through to doing what’s right policy-wise in a way that doesn’t harm their presidential prospects.”

Nevertheless, The wonks expect better.

“Today’s deficits are a function of discretionary spending, but tomorrow’s debt crisis — which is what has our creditors worried and what threatens our future prosperity — is all about our health entitlements, and especially Medicare,” said Yuval Levin, a former aide to George W. Bush who edits the conservative policy journal National Affairs and is also a fellow at the Ethics and Public Policy Center. “It is no longer possible to be a serious fiscal conservative without taking up meaningful structural reforms of Medicare.”