Health and Human Services Secretary Mike Leavitt called lawmakers to action on Tuesday during a speech on the need for Medicare reform.

Comparing the ups and downs of healthcare to whitewater rafting and canoeing, Leavitt noted that the cost of healthcare will nearly double over the next 20 years in terms of both government spending and individual household spending. At the same time, he noted, the ratio of workers per Medicare beneficiary will drop from four to two-and-a-half.

Leavitt suggested a trigger to tie the program to reform, such as the percentage of the gross domestic product taken up by the program. Such a trigger would force Congress to implement reforms. He also suggested raising taxes, cutting benefits, and reducing payments to providers, though he acknowledged that these possibilities “represent the ugliest of political dilemmas.”

See the text of Leavitt’s remarks at http://www.hhs.gov/news/speech/2008/sp20080429a.html.