When Republicans talk about reforming Medicare what they really mean is to turn it into a voucher program, freeze benefits and over time, let the 'free market' destroy what's left.
When a progressive talks about reforming Medicare the first item on the list if negotiating with the nations drug companies so as to leverage their buying power to get the best prices possible. If it's good enough for the VA to have negotiated for the price that veterans pay for their drugs why is it not good enough for the rest of us? Of course the Republicans have also been talking about privatizing the VA so I assume that that's how they intend to rationalize the differences between the two drug plans.