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Since the Ryan–Wyden proposal is based on working principles, there are still many policy questions to resolve. For example, it is silent on the future of Obamacare. Make no mistake: Structural Medicare reform should begin after full repeal of Obamacare. Furthermore, given the depths of our fiscal crisis, the proposal is slow to take effect. The Heritage proposal (http://eng.am/vXRGCN) transitions to premium support beginning in 2016; Ryan–Wyden does not begin until 2022, the same date embodied in the House budget resolution.

Nonetheless, Ryan–Wyden continues the conversation about the need for fundamental structural Medicare reform. Trying to save Medicare through more government price controls will not do. Converting the outdated Medicare program into a premium-support model is the best and more honest way forward (http://eng.am/v8wSp9).