As President Barack Obama and congressional leaders continue discussions to avert the so-called fiscal cliff, we hear a troubling but familiar refrain in Washington: To fix our deficit, we must cut Medicare benefits. That is flat-out wrong. We have a systemwide health care cost problem in America. Health care expenditures are nearly 18 percent of our gross domestic product. The next least-efficient developed country in the world spends 12 percent of its GDP on health care. Leaders of both parties have acknowledged this dilemma. As Republican vice presidential nominee and House Budget Committee Chairman Paul Ryan has said, "If you want to be honest with the fiscal problem and the debt, it really is a health care problem."