Critical Condition.(A)(EDITORIALS)

Medicare: In Washington, reform in theory is often better than reform in practice. We hope the president's reorganization of the federal hospital and health care insurance program for the elderly doesn't disappoint.

Encouraging is this White House's willingness to change federal programs most in need of reform. We include President Bush's support for private Social Security accounts as well as the ideas on Medicare reform he's expected to outline this month. Both programs are unsustainable in their present condition and need foundational reforms if they're to avoid economy-wrecking collapses.

It's not clear just what changes Bush has in mind for Medicare. But it appears he will propose introducing competition that will pit private insurance plans against Medicare's services.

Lawmakers and activists who fear change more than the demographic trend that will wipe out Medicare won't like that. But competition is just what Medicare needs.

The nature of competition always benefits consumers, who are, in this case, the elderly in need of health care.

Because rival providers fight for market share, competition keeps costs down and improves services.

While Bush will take flak from ...