Keith Hennessey, who has been among the more intellectually honest opponents of health care, makes his final pitch:

The pending legislation slows the growth of Medicare spending, but then spends that money on the new promise.  We still have the old unfunded promises, and those relatively easy Medicare policy changes will no longer be available to fund them.

When you or your successors choose or are forced to solve our long-term fiscal problem, these tools will be unavailable.

You will have to reduce benefits and charge seniors higher premiums, copayments, and deductibles.  You will have to cut provider payments even more.  You will have to means-test benefits more aggressively.  You will have to raise the eligibility age for these programs.  If you favor tax increases, you will find yourself evaluating options to raise them not just on the rich, but also on the middle class. The arithmetic will force you to do these things.

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