Romney campaign officials say Medicare savings will come through competition among health insurance plans. But independent experts say they doubt that Romney's plan can succeed without some kind of hard spending-limit.

"It sounds like Romney is trying to have it both ways," said Robert Bixby, executive director of the Concord Coalition, a nonpartisan group advocating to reduce government deficits. "It's a really important point whether there will be a cap. It will help determine whether the health care savings he's touting are credible." . . .

In the world of private business, competition hasn't solved the health care cost problem for employers, who increasingly have been shifting costs to workers and their families in the form of higher premiums and copays. "Competition alone is very speculative," Bixby said.