We have made promises in Medicare that cannot be kept, and we have compounded those promises with the Medicare Modernization Act.

Medicare Part D — delivering prescription drugs to seniors — has been a success since President Bush introduced it. And the Obama administration plans to threaten that achievement.

Reforms that go beyond prescription drugs are needed if the program is to survive the financial pressures created by the baby boomers, who will double Medicare enrollment by 2030.

The new prescription drug benefit will be a fiscally irresponsible subsidy with astronomical long-term costs.

President Barack Obama and key congressional Democrats want a better deal on prescription drugs sold to seniors. But if they get it, seniors will pay billions of dollars more for their medicines.

Rep. Paul Ryan claims that huge savings under Medicare's Part D prescription drug program proves that competition will work for the full program. His critics argue that the savings have nothing to do with competition. As happens so often in Washington, both sides are focusing on the wrong issue.

Many on the political left decry the disappearance of defined-benefit pension plans from the private sector and strive mightily to maintain them for public-sector employees. The people who put defined-benefit plans and policies in place assumed there would always be someone able to pay for them.

The cost of developing drugs is rising at an unsustainable pace, new company formation in the biotech sector has dwindled, and healthcare costs continue to rise. We must craft policies that provide the proper incentives for new technology while making sure that we are getting more value for programs like Medicare.