The other "third rail of politics"

The late House Speaker Tip O'Neill once called Social Security the "third rail of politics" — meaning anyone who touched the program risked instant death, at least politically. If O'Neill were still around, he might say the same thing about Medicare.

It was Medicare, apparently, that turned the tables in Tuesday's election in upstate New York, where Democrat Kathy Hochul won a special election in a traditionally Republican district. Hochul's campaign emphasized her opposition to Republican Rep. Paul Ryan's plan to turn Medicare into a voucher program — instead of the government paying directly to providers for the health care of Medicare recipients, Ryan would reduce costs by giving vouchers for recipients to purchase their own health care in the private sector.

What is interesting is that both parties have recognized that the current Medicare program is unsustainable. Some type of reform is necessary. President Obama took a lot of heat because his health care program required cuts in Medicare reimbursements to save money. Republicans screamed. President Bush had proposed cuts in Medicare reimbursements, too. Democrats had screamed. Tuesday's election indicates that we may have reached a point at which no one can afford to reshape Medicare, and both parties see Medicare changes as an invitation to attack the other party. This will lead to an impasse in which Medicare costs outgrow taxpayers' ability to pay for the program.

Then what?