More than a month after the trustees of the Social Security and Medicare Trust Funds gathered in late March to issue their annual report on the funds' race to insolvency, the Secretary of Health and Human Services issued another.

It's a call to action — with a warning that "Medicare is drifting toward disaster."

Disaster is not inevitable, says HHS Secretary Mike Leavitt, but unless something is done the nation is endangering, and stealing from, the quality of life of young families and children to come. What's happening is that an increasing share of the earnings of the young will be taken to provide retirement and health care for the old.

"When I was born," said the 57-year-old Leavitt, health care consumed 4 percent of the economy. "When my son was born it had doubled to 8 percent. When my first grandson was born two years ago, it had doubled again to 16 percent."

The first of the baby boomers to qualify for Social Security became eligible this January. At present, 12 percent of the population is 65 or older, noted Leavitt. By 2030, it'll be almost 20 percent. In three years the first of the baby boomers will become eligible for Medicare. Its hospital insurance trust fund is projected to become insolvent in 11 years, 2019.

An aging population. Medical costs growing faster than other segments of the economy. A diminishing number of workers per retiree paying Medicare taxes. And, by the Center for American Progress analysis, earnings that are flat or falling for young workers 25-34, combined with a higher debt and housing-cost burden.

"Higher and higher costs are being borne by fewer and fewer people," said Leavitt. "Sooner or later this formula implodes."

An analysis of recent public opinion polls by the Washington-based Center for American Progress, an advocacy group that seeks to "expose the hollowness of conservative governing philosophy," prompts the group to conclude that "declining incomes, growing debt, and high costs of education, home ownership and health are conspiring to make this generation the first to not surpass the living standards of their parents."

The reference is to the so-called Millennials, those born in the 1980s and 1990s, most of whom would now be in their 20s. It's a large generation — 80 million to 95 million, depending on the years chosen to define the group — compared to about 76 million for the baby boom generation born between 1946 and 1963.

What to do? If nothing changes, Congress will be forced to act in crisis — raising taxes, cutting benefits or forcing doctors, hospitals and other health care providers to take less for their services. That gets nasty.

"Some of these choices represent the ugliest of political dilemmas, pitting a generation of workers against their parents and grandparents," said Leavitt in one of a series of policy speeches he is delivering as the Bush administration winds down.

He and his wife have a son, age 30, just on the edge of the Millennial generation. "He and his wife are just beginning their household. They have one young daughter and another baby on the way."

Over the next two decades, that young family and others like it will see health care spending that rises from 23 percent of total compensation to 41 percent, while the share of federal spending that pays for Medicare will rise from 13 percent to 23. Meanwhile, the number of workers supporting each Medicare beneficiary will drop from four to two.

Leavitt spells out three imperatives.

The first is to "separate commitment from pain." By that he means new legislation is needed with "trigger points" built in "so members of Congress are not casting a vote to take specific measures but rather [are] laying contingent plans if things go beyond a predetermined point." Something similar exists now. If, for example, 45 percent of Medicare's total costs have to come from general revenues and not payroll taxes and premiums, a process is triggered requiring the president and Congress to act to fix the problem.

The second is to "pick the right moment" to establish a legislative process similar to the base closure commission to address Medicare, as proposed by Sens. Judd Gregg (R-N.H.) and Kent Conrad (D-N.D.). Both parties, he says, would have to agree to operate under its rules regardless of which party has the majority.

The third is to "modernize scoring conventions." As an example, an investment in new technology, such as electronic medical records, would be considered by the Congressional Budget Office to be a cost. That's true initially, but long-term, it should produce savings.

In this presidential campaign, there's been little discussion and few meaningful proposals for addressing the generational conflict to come. The first step, as Leavitt proposed, is to change the decision-making process to get Medicare out of the nearly nonstop election cycle.

Young families can't handle the financial burden the nation is about to impose on them.

— Jim Wooten, for the editorial board