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Much is at stake when it comes to Medicare reform--not only the program's future but also the nation's fiscal flexibility to pursue other important national goals and programs in the future. A comprehensive effort to reform Medicare and put it on a sustainable path would help fulfill this generation's stewardship responsibility to succeeding generations. It would also help to preserve some capacity for future generations to make their own choices for what role they want the federal government to play. Updating Medicare's benefit package may be a necessary part of any realistic reform program. Such changes, however, need to be considered in the context of Medicare's long-term fiscal outlook and the need to make changes that will sustain the program over the long-term. Specifically, adding prescription drug coverage to the Medicare program would have a substantial impact on program costs. At the same time, many believe it is needed to guarantee the financial well-being and health of many beneficiaries. The challenge will be to design and implement drug coverage that will minimize the financial implications for Medicare while maximizing the positive effect of such coverage on Medicare beneficiaries. Most importantly, any substantial benefit reform should be coupled with other meaningful program reforms that will help to ensure the program's long-term viability.

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