One of the casualties of the presidential campaign could be the potential for a constructive look at Medicare.

Both candidates are busily assailing the other’s ideas for controlling Medicare costs, essentially as a way to scare up votes from seniors.

The Romney-Ryan ticket says President Barack Obama’s health reform changes to Medicare will cut $700 billion from the program. Obama says Rep. Paul Ryan’s budget turns Medicare into a voucher system that will leave seniors short when it comes to covering medical costs.

For the record, Obama’s criticisms are closer to the mark, and Romney and Ryan are talking absurdities. The president’s health reforms extract savings from Medicare mostly by cutting reimbursements to hospitals and from the Medicare Advantage program.

Meanwhile, it’s true that Ryan’s plan seeks to control Medicare costs simply by cutting the government’s obligation to recipients and hoping that competitive bidding keeps the costs in line. (And at least one of Ryan’s budget-balancing plans leaves in place the Medicare savings advanced under the Affordable Care Act.)

The difference between the two plans is not as much in whether there are cuts, but in who bears the brunt.

Obama would take his savings from insurers and hospitals. Romney-Ryan would get them from seniors.

The problem, though, is that the campaign sound bites do not flesh out that distinction. They’re focused more on simple blame for political advantage — which, in turn, could make it harder yet to grapple with the nation’s budgetary problems after the election.

The danger here is real, and pressing. Before the winner of the election is inaugurated, Congress must confront the “fiscal cliff” set up by the deal last year to extend the debt ceiling.

Billions in tax increases and automatic, presumably across-the-board cuts are set to take effect by Jan. 1. The only responsible way to avoid that is by enacting more precise reductions and carving out more targeted revenue increases.

That can’t be done without looking seriously at Medicare and other social programs, to see where their spiraling costs can be reasonably contained.

A Congress cowed by a brutal, surface argument about Medicare during the campaign won’t likely grow enough spine to grapple with these questions post-election. And the result could either be a disastrous set of choices, or essentially no choice at all — kicking the proverbial can that is the federal budget further down the road, as debt and deficits continue to spiral.

The Obama campaign has the substantive advantage in the Medicare argument, but needs to be sure that its criticisms of the Ryan voucher program do not imply that Medicare won’t need fixing, or that, ultimately, some benefit changes or reductions might be necessary.

The Romney-Ryan campaign needs to be honest that its plan could open a new Medicare gap for seniors, and explain why that’s acceptable to the GOP. The canard that Obama would cut Medicare more deeply is fantastically erroneous, even for campaign tripe.

Neither side should let election hyperbole squelch the chance for the cooler-headed dialogue about the nation’s budget, including Medicare, that will still be essential even after the votes are counted.

Editorial by the Detroit Free Press

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