I received my Medicare card the other day, recognizing my 65th birthday and making me part of one of America's biggest problems. By this, I mean the burden that the massive baby-boom generation will impose on its children and the nation's future. There has been much brave talk recently, from Republicans and Democrats alike, about reducing budget deficits and controlling government spending. The trouble is that hardly anyone admits that accomplishing these goals must include making significant cuts in Social Security and Medicare benefits for baby boomers.

If we don't, we will be condemned to some combination of inferior policies. We can raise taxes sharply over the next 15 or 20 years, roughly 50 percent from recent levels, to cover expanding old-age subsidies and existing government programs. Or we can accept permanently huge budget deficits. Even if that doesn't trigger a financial crisis, it would probably stunt economic growth and living standards. So would dramatically higher taxes. There's a final choice: deep cuts in other programs, from defense to roads to higher education.

Yet, neither political party seems interested in reducing benefits for baby boomers. Doing so, it's argued, would be "unfair" to people who had planned retirements based on existing programs. Well, yes, it would be unfair. Indeed, it's hard to imagine a worse time for cuts. Unemployment is horrendous; eroding home values and retirement accounts have depleted the elderly's wealth. Only 19 percent of present retirees are "very confident" of having enough money to live "comfortably," down from 41 percent in 2007, reports the Employee Benefit Research Institute.

But not making cuts would also be unfair to younger generations and the nation's future. We have a fairness dilemma: Having avoided these problems for decades, we must now be unfair to someone. To admit this is to demolish the moral case for leaving baby boomers alone. Baby boomers - I'm on the leading edge - and their promised benefits are the problem. If they're off-limits, the problem is being evaded. Together, Social Security, Medicare and Medicaid represent two-fifths of federal spending, double defense's share.

Solutions are clear. Social Security's eligibility ages (66 now for full benefits and 62 for reduced benefits) could be gradually raised. Benefits could be cut for wealthier retirees. At 65, new Medicare beneficiaries could pay some or all of their insurance costs until they reached eligibility for full Social Security benefits. Even then, better-off recipients could pay higher premiums. These and other changes should start soon - in a few years once the recovery strengthens.

Confession: I've written columns like this for years. Little has changed. Medicare premiums for wealthier recipients (income thresholds: $85,000 for individuals, $170,000 for couples) have increased modestly, affecting about 5 percent of beneficiaries. But politicians fear making major changes. They dread an assault from AARP, the main senior lobby, and the rage of millions of retirees and near-retirees. Public opinion is hostile. It's high on reducing deficits and low on changing the programs that create the deficits. In a recent Pew poll, 58 percent of respondents opposed higher Social Security eligibility ages and 64 percent rejected higher Medicare premiums.

As a society, we've recoiled from a candid discussion of public and private responsibilities for retirement. The long-ducked question is how much government should subsidize Americans for the last 20 to 30 years of their lives. Social Security and Medicare have evolved from an old-age safety net into a "middle-age retirement system," as Eugene Steuerle of the Urban Institute puts it. In 1940, couples reaching 65 lived an average of almost 19 years, Steuerle notes. Now, the comparable figure for couples is 25 years. For Americans born today, the estimate approaches 30 years.

Overhauling Social Security and Medicare has many purposes: to extend people's working lives; to make them pay more of the costs of their own retirement, as opposed to relying on subsidies from younger Americans; to prevent spending on old-age welfare from crippling other government programs or the economy; to create a bigger constituency for cost control in health care. America's leaders have tiptoed around these issues, talking blandly about limiting "entitlements" or making proposals of such complexity that only a few "experts" understand.

Just because this is an awful time to discuss these questions does not mean they shouldn't be discussed. The longer we wait, the more acute our fairness dilemma grows. We can't deal with it unless public opinion is engaged and changed, but public opinion won't be engaged and changed unless political leaders discard their self-serving hypocrisies. The old deserve dignity, but the young deserve hope. The passive acceptance of the status quo is the path of least resistance - and a formula for national decline.