In just 12 years, Medicare will be broke. So, the question remaining is not whether Medicare will be reformed, but how.

During the first two presidential debates, neither Barack Obama nor Mitt Romney denied that Medicare's upside-down accounting has put the program on a path toward bankruptcy, but, not surprisingly, each had a very different vision on how we keep our promise to America's seniors. And the differences in those visions matter.

Through his health care reform legislation, Obama cut $716 billion from Medicare's bottom line to use in other programs, and put in place a board of unelected, unaccountable bureaucrats that will insert the federal government between doctors and patients. During the first presidential debate, Obama explained the board like this, "When Gov. Romney talks about this ... unelected board that we've created, what this is, is a group of health care experts, doctors, et cetera, to figure out, how can we reduce the cost of care in the system overall?"

The president's top-down plan empowers the Independent Payment Advisory Board to tinker with reimbursement rates for doctors and hospitals -- to pay physicians less and less in order to stick to an arbitrary schedule of spending cuts. If you don't think that will affect your care, you're wrong. If reimbursement rates are reduced even further below market value, as many as 15 percent of hospitals could close, according to Medicare's own actuaries. Up to 40 percent of doctors, according to some estimates, may stop seeing Medicare patients completely rather than take the massive pay cuts that will be imposed by federal bureaucrats.

By cutting reimbursements without putting strategies in place that reduce the underlying cost of health care, IPAB will limit the availability of care and effectively ration services for millions of America's most vulnerable patients.

On Medicare, the choice this November couldn't be starker. Mitt Romney has promised to repeal Obama's Medicare plans on Day 1 and replace them with a program that encourages competition between the private sector and government. Romney explained during the debate, "What I do to make sure that we can keep Medicare in place for [people who are young] is to allow them either to choose the current Medicare program or a private plan. Their choice."

Under Romney's plan, Medicare would not change for anyone who is currently 55 years of age or older. For those who are not yet 55, Romney has proposed a premium support program that puts the choice of health care coverage in the hands of seniors, not the government. If Medicare is the best option, future seniors will still have access to the program, but if there is a more affordable or higher quality plan in the private sector, older Americans will have the choice to leave traditional Medicare and pocket any savings.

Whereas President Obama's top-down approach only lowers the amount the federal government will pay for services, Romney's proposal introduces competition into Medicare in order to drive down the cost of health insurance and provide an incentive to improve and innovate current plans for seniors.

Medicare's unfunded liabilities are not sustainable. On average, couples that retired in 2011 paid $150,000 in Medicare taxes throughout their working lives, but over the coming years, will receive more than $350,000 in benefits. On Medicare, voters have a very clear choice this November, and with just 12 years before the program goes broke, this election will determine the future of America's greatest promise to seniors.

Music legend Pat Boone is the national spokesman for the 60 Plus Association, of which Jim Martin is the founder and chairman.