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But supporters of the Ryan plan say that there is so much waste, redundancy and duplication of services in Medicare and Medicaid that significant cuts wouldn’t hurt the level of care.

Medicare is so incredibly wasteful that a key part of providing better health care to seniors is spending less on them,” said Michael F. Cannon, director of health policy studies at the Cato Institute, a free-market Washington think tank. “That’s how far into the land of too much health care we are, it’s how wasteful Medicare is.”

Mr. Cannon said the CBO figure, while accurate, is misleading because seniors wouldn’t be spending money on unnecessary medical procedures, prescriptions and doctor visits - extras critics say are common because of Medicare’s guaranteed doctor reimbursements.

Seniors “are not going to be shelling out that much more out of pocket” than under the current Medicare plan, he said. “They’ll just decide to go without some stuff that they don’t need, including choosing another health plan that help them avoid waste in care.”

The president will lay out a Democratic alternative that includes entitlement programs during a scheduled Wednesday address to the nation.

Because Mr. Obama mostly ignored entitlement reform in his 2012 budget blueprint, some critics have suspected his strategy was to wait until the GOP addressed the issue before criticizing them for drafting an unworkable plan.

“What remains to be seen is on Wednesday night is the president going to say, ‘Hey, I’ll work with you guys, I just wanted to see where you were going to come out first?’ ” Mr. Cannon said. “Or is he going to vilify them and use it as a campaign issue and bludgeon Republicans?”

c This article is based in part on wire service reports.