The Democrats are beginning to remind me of a dear, old friend of mine who lives in a small southern town where her uncle was president of the local bank. Once upon a time, when her checking account was severely overdrawn, her uncle took it upon himself to call personally to deliver the bad news. “I’m so sorry,” she exclaimed. “Let me just write a check to cover that.”

The Democrats who were gleeful (or said they were) to get Paul Ryan on the GOP ticket so they could Mediscare older voters are having a rude awakening. The country is ready for a serious conversation about Medicare. Unless you live at 1600 Pennsylvania Avenue, you know that the nation's bank account is being depleted.

Irwin Stelzer gives perhaps the most succinct summary of the Medicare dilemma that I’ve seen:

The end of Medicare and Medicaid as we know them—through reform, the Ryan way, or -bankruptcy, the Obama way. The direction of the country—via the Romney-Ryan right track, or the Obama-Biden wrong track. Those are the choices, made stark by the addition of Paul Ryan to the Republican ticket….

So the choices on offer are continuing full speed ahead towards the fiscal cliff—the Obama plan—or adopting some version of the Ryan reforms. It is not between some viable Obama plan, nowhere in sight, and the Ryan plan; it is between denial and a willingness to face hard facts.

Stelzer, who obviously didn’t know my check-writing friend, compares the situation to a scene in an Elaine May-Walter Matthau movie (A New Leaf) in which the Matthau character just doesn’t understand it when his lawyer repeatedly explains that he has spent his inheritance and is broke.

Candidate Barack Obama in 2008 admitted that Medicare was in trouble, but he seems to be in denial now. Does he have a plan to fix it in a second term? An editorial in this morning’s Wall Street Journal addresses the issue:  

What [President Obama] rarely mentions is how he plans to fix Medicare under ObamaCare. First the government will do things like arbitrarily commanding providers to deliver the exact same benefits except for $716 billion less. When that doesn't work, as it surely won't, the feds will take control of the case-by-case decisions currently made between patients and doctors and substitute the judgment of technocrats. (See what's already happening in Massachusetts, "RomneyCare 2.0," August 6.)

ObamaCare does this by empowering an unelected 15-member panel to rule over medicine and tell doctors how to practice, with no legislative or judicial review. Before he decided to fire up Mediscare again, Mr. Obama used to concede that this form of rationing by elites was inevitable. In a 2009 interview with David Leonhardt, he mused whether his own grandmother's hip replacement after a terminal cancer diagnosis represented "a sustainable model" for society.

Paul Ryan and Mitt Romney, the editorial notes, are proposing an alternative. The Democrats, unable or unwilling to propose anything more than writing checks on overdrawn accounts, have caricatured the GOP plan, erroneously telling older voters that seniors will have to pay $6,4000 in higher health costs. But what the Republicans are proposing is nothing of the sort:

Their "premium support" reform explicitly preserves traditional fee-for-service Medicare. Starting in 2023, seniors could either pick traditional Medicare or choose from a menu of regulated private plans. The reform is modeled after the health program that already covers all federal workers, including Members of Congress. The subsidies increase with health costs, so seniors wouldn't bear more risk.

The plan wouldn't kick in for a decade, shielding everyone who is in or near retirement. Our preference would be to start immediately, but the delay is one of many political accommodations to help ease the worries of current retirees.

The Democrats are trying to use Mediscare against Romney-Ryan. But it may not work because it is dawning on Americans—including older ones—that the present system can't continue without reform. In a way, the bad economy, Greece’s and California’s economic woes, which show what happens when the national bank account is overdrawn, have made this debate not only possible but mandatory.