There's nothing make-believe about Medicare Part A's impending insolvency.

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If you're already on Medicare or counting on it when you retire, you're in for a shock. Medicare Part A — the fund that pays hospital and nursing home bills — is running out of money. A mere seven years from now, it will no longer have enough funds to pay your providers' bills in full. Medicare trustees sounded the alarm in June, urging Washington lawmakers to act "as soon as possible" to protect people "already dependent" on the program.

Good advice, but don't expect most politicians to take it. The Democrats running for president are in fantasyland, proposing to expand Medicare to millions of younger people, or even to the entire population through "Medicare for All" — never mind Medicare's insolvency. That's like a family that can't pay its mortgage going shopping for a mega-mansion.

Amazingly, in four national debates so far, not one moderator has asked the presidential wannabes how they would secure Medicare's finances and keep the promise the nation has made to seniors. As if 65-and-overs don't count.

In contrast, President Donald Trump is taking steps to avert Medicare's meltdown. Last week, he stressed his commitment to "securing and improving" Medicare. His budget slows the growth in Medicare spending by trimming what hospitals and other institutions are paid. Another change will allow knee replacements to be performed at ambulatory surgery centers, which are lower-cost. The idea is to stretch the money in the Medicare insurance fund and make it last longer.

Predictably, Trump's political opponents are trying to torpedo his efforts. A new digital ad by the Democratic-leaning group Priorities USA in battleground states like Michigan claims Trump is cutting Medicare "just to pay for tax cuts for billionaires." It's a blatant lie, and even the left-leaning Washington Post and PolitiFact admit that.

Medicare Part A is funded through a payroll tax paid by employers and employees. As soon as the tax revenue is collected, it's spent. Today's workers and employers fund health care for today's seniors. The trouble is, there are too many boomers retiring, compared with the number of workers paying the tab.

Economists have been warning for years about this impending shortfall. Fixing it is another matter. During the 2012 presidential election, when Republican vice presidential candidate Paul Ryan proposed Medicare reform, Democrats ran a TV ad depicting Ryan gruesomely rolling a wheelchair-bound granny off a cliff. The bitter lesson was demagoguery works. Don't level with voters about the problem. Just make big, impossible promises.

That was eight years ago. Every year since, Medicare trustees have warned about the program's slow slide into default. But Washington's cowardly politicians stayed mum.

Shoring up the program will require curbing benefit costs, hiking the payroll tax or inching up the eligibility age to slow enrollment growth.

The longer politicians dither, the fewer options remain available. A decade ago, the most painless approach was to raise the eligibility age of 65 by a month each year so that 12 years later the eligibility age would be 66. This gradual approach would have given future retirees plenty of advance notice.

Increasing payroll taxes is a nonstarter; it threatens to drag down the economy and clobber low-income workers disproportionately.

Currently, Trump is using his only option. He's reducing benefit costs by cutting what hospitals and other providers are paid. Any other remedy would require Congress' cooperation, which is unlikely.

Meanwhile, Bernie Sanders, Elizabeth Warren and other backers of Medicare for All are making big promises with no way to pay. Sanders has proposed several tax hikes, but altogether, they wouldn't foot the bill for even half the estimated cost of his program. It's make-believe math.

There's nothing make-believe about Medicare Part A's impending insolvency. Some 61 million seniors depend on Medicare and have no other means of paying their hospital bills. Millions more will become dependent on Medicare in the next six years.

For White House contenders to ignore this crisis, which will have to be solved during the next presidential term, is a slap in the face to seniors and middle-aged Americans.

Betsy McCaughey is a former lieutenant governor of New York State. 
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