Schmitt, as always, is worth listening to. I would add that, from what I understand of health policy, restraining growth in Medicare — where the real money is — entails getting a hold of health care spending in general. If Medicare reimbursement rates, say, start plummeting relative to private insurers, that will mean fewer hospitals taking Medicare patients at all. The problem, then, is that deficit reduction is a poor venue for reforming Medicare, where the question of private health spending is nonexistent.