Bill Kristol, appearing on Bill Bennett’s radio show, put it best: Those Republicans running from Rep. Paul Ryan’s Medicare reform plan are “pathetic.” A loss of a single House seat in a special election in New York has some of the mice on Capitol Hill and the hysterics in the right blogosphere predicting disaster in 2012 and/or the end of Ryan’s political career. One is tempted to tell them to “man up.”

Timidity is not a rare commodity among political insiders. It’s the mentality that says Charlie Crist is a safer candidate than Marco Rubio. It’s the hand-wringing that caused some Republicans to urge we forgo the surge in Iraq, lest the Republicans lose the House.

So should Republicans cower under the bed — forfeiting any claim to responsible leadership — or make the case for real reform. As an infuriated Republican activist, Michael Goldfarb, put it, that there is an easy response to all the Mediscaring: “Ryan is trying to save Medicare and the country, while Obama pretends everything’s okay and destroys both.”

Mainstream media headlines blast that yesterday the Ryan budget was defeated 57-40 in the Senate. True, but when the president’s plan goes down 97-0 and conservative Sen. Pat Toomey’s proposal gets 42 votes, is it really time to wave the white flag?

Conn Carroll of the Washington Examiner argues:

Republicans cannot keep playing defense on Medicare and hope voters will see the light. They need to aggressively go negative on the Democrats failure to produce a viable Medicare plan. They need to explain how this well hurt seniors and that the pain is coming a lot sooner than they think

Carroll adds an important observation: “In order to preserve the fantasy that Obamacare was deficit neutral Democrats preserved Clinton-era doctor payment formulas that are scheduled to cut doctor Medicare payments by 29.4% in 2012. . . . Independents need to be told that Democrats want to pay their doctors 30% less to provide them health care. At that point, they’ll be able to figure out the waiting list/denied care argument on their own.”

The message is not so complicated, but it needs to be made forcefully. Republican superstar Sen. Marco Rubio (R-Fla.) shows how to do it:

That’s a message other officeholders and presidential aspirants need to make as well. The latter didn’t vote for Ryan’s plan, and they are, as Rubio notes, certainly capable and free to propose their own suggestions, but the core message should be the same: Doing nothing is going to destroy “Medicare as we know it.”

Yuval Levin wrote:

[T]he new Medicare Trustees report says the program is five years closer to bankruptcy than it seemed to be last year: Its trust fund will run out of money in 2024. But the real shocker in this year’s report is a letter that the chief actuary of Medicare attached to the very end of the report, basically saying that things are much worse than the trustees suggest. The letter (which starts on page 265 of the document and pretty much makes the prior 264 pages moot) first says that the trustees were compelled to adopt some near-term assumptions that are highly implausible.. . .

Then it says that Obamacare, because it calls for across-the-board cuts in Medicare funding but does not put in place the market mechanisms for encouraging greater productivity in health care, spells disaster for Medicare providers, and therefore for Medicare recipients

In other words, as Yuval put it, the message for Republicans (whether they embrace Ryan’s plan or not) is: “Medicare as we know it is on the fast lane to ruin. It’s not the House Republican Budget that is undoing it, it’s the current structure of the program, exacerbated by Obamacare. House Republicans have proposed one way to fix it, which would also help reduce health-care costs more broadly. Surely there are also other ways, but the Democrats haven’t offered any.”

Is that really so hard to explain to the American people? Well, it is if you’re gnashing your teeth and figuring out how to distance yourself from the one responsible effort out there. The good news: 40 senators stood their ground yesterday in voting for the Ryan budget. Now they (and every member of the House who has voted for Ryan’s Medicare plan) need to explain why.