After eight years of Republican rule, some guy starts to write about Medicare reform for the artificially-funded Weekly Standard.
No leadership for eight years, for political reasons no doubt; but the editors there are brazenly willing to call on the next administration to be Responsible.
Nothing surprising in the suggested 'reform': nothing on driving costs out of the system (using single-payor leverage or otherwise), but plenty on dropping people/coverage by limiting payouts (the block-grant model).
Btw, abuse of earmarks is highly corrosive to good governance. A lot of them look like self-dealing. Ending abuse is on par with overall fiscal responsibility, I think, in terms of putting the house in good order.