It’s no secret that Medicare and Social Security spending is growing out of control.

Plans to cut Medicare spending have mostly focused on cutting reimbursement rates to doctors and hospitals, instead of reducing benefits.

The Topeka Capitol Journal reports that “Senator Jerry Moran told the Greater Topeka Chamber of Commerce on Tuesday that the current Medicare payment model is unsustainable, particularly in rural areas with high percentages of senior citizens, because eventually doctors and hospitals will close up shop when they are paid less than it costs to deliver health care.

Moran serves on the Senate Appropriations Committee, which controls about 30 percent of government spending.

Though it is politically difficult, Congress will need to consider means-testing and other ways to determine who is eligible for Medicare and how much assistance those who are eligible should receive, Moran said.

“I’ve explained this to senior citizens and I think most are willing to have a serious conversation.”