Electoral politics has become so polarized and nonstop that few candidates dare discuss national problems honestly. Anyone looking for a rational debate on the future of Medicare, for example, hears instead that it is either a promise the country must keep or part of President Obama’s socialistic plot to destroy America. Meanwhile, everyone knows it can’t be sustained at current levels without serious tradeoffs. And paying for even a more limited system, in the unlikely event politicians agree to one, would be difficult.

Ann McLane Kuster, the Democrat who will try to unseat U.S. Rep Charlie Bass this fall, weighed in on the issue. “What we shouldn’t do is sit on our hands as some in Congress try to cut the benefits our seniors have earned in order to make room for massive tax cuts for the wealthiest Americans and companies that ship jobs overseas,” she argued.

If only the choice were so easy. Raising taxes on high earners and keeping jobs in this country are good ideas, but there is no way they will produce enough revenue to pay the growing bill of Medicare. Nor will Kuster’s other suggestions, cutting federal travel allowances and oil company subsidies.

As Kuster rightly observed, Bass’s vote for a Republican budget plan that would reshape Medicare through vouchers and privatization was odious. We’re already seeing what the switch to privatization did for pensions. Millions of Americans now face retirement or late-career layoffs without the means to support themselves in old age. Privatizing Medicare would further widen the gap between rich and poor, and the moral consequences would be dire.

Although you wouldn’t know it from the rhetoric of the campaign, there are obvious approaches to Medicare reform. To begin with, it would help if Medicare recipients knew the actual cost of the care they received. The paperwork the system provides would befuddle even an accountant. It would also help if the system did not reward doctors for ordering medical tests of little or no value.

But most of all, Kuster is wrong when she asserts that Americans over 65 have earned their Medicare. In nearly all cases, their medical costs vastly exceed the payments they made into the system during their working lives. This suggests that on a scale based on income and assets, they should be paying for a larger portion of their medical care rather than foisting the costs off on younger generations of taxpayers.

One popular suggestion is to increase the Medicare eligibility age along the same lines as Social Security, whose retirement age for full benefits has slowly risen since the 1980s. Though simple and logical, this idea seems less appealing considering the fate of older workers in the current economy.

National political campaigns, especially during the on-the-ground phase that New Hampshire voters know so well, used to be forums for specific ideas on the challenges facing the country. Now they’re 24/7 multimedia gotcha fests that polarize candidates and parties from start to finish.

Kuster, a smart candidate with humane instincts, needs to rise above the either-or party line and give voters a true picture of Medicare. It’s not easy in the current political climate to tell voters the real choices that must be made to sustain and strengthen the program. But the best members of Congress face reality and speak their minds.

— The Concord (N.H.) Monitor