How to Reform Medicare, Without the Ryan Plan

In the “fiscal cliff” talks, Republicans are demanding serious entitlement reforms in exchange for an agreement to raise revenues. But in the aftermath of the November election, what kinds of reforms should be on the table, especially in the Medicare program? President Obama made clear during the campaign his opposition to the one idea that could really make a difference — premium support of the kind developed and championed by the Republican vice presidential candidate, Paul Ryan. That’s the most direct route to injecting the kind of market discipline that Medicare and the rest of the health system desperately need.