In looking at the President's stated goals (which have been public since 2001), his reforms appear to be on the side of granting greater individual choice for beneficiaries (a conservative principle, I think), and a leaning toward marketplace solutions (coverages similar to what one finds in the marketplace). The Administration's proposals for Medicare will cost more, this is true. But the structure of Medicare produced by the reforms will set the system up for greater reforms, and more reliance upon free market solutions, than the current system we have. Unless one favors the outright repeal of Medicare, I don't know how this calls in fire on our positions.
No, IMHO the biggest issue is security. If you don't secure our borders, it is impossible to defend us from terrorism. Until the borders are secure and all illegals are thrown out we are setting ourselves up for another 9-11.