WASHINGTON (AP) — Health care savings in President Barack Obama’s deficit-reduction plan would squeeze future Medicare recipients, cut payments to drug companies and hospitals, and shift costs to states.

Still, some advocates say the president’s approach is less painful than other major ideas being debated this year, from privatising Medicare to letting the states run Medicaid without a federal guarantee that the poor would get needed care.

“This is a question of ‘compared to what?’” said John Rother, president of the National Coalition on Health Care, a research and advocacy group. “I would describe this as an attempt to spread the pain pretty broadly. While it does hit Medicare beneficiaries, it’s better than most of the alternatives we’ve seen thus far, which would involve bigger hits.”

Obama did promise Medicare beneficiaries that he’d veto any legislation asking them to sacrifice without also raising taxes on upper-income earners. But he didn’t issue them a complete pass.

Instead, his administration is borrowing from corporate America’s playbook by proposing to raise a range of costs for future retirees, while mostly shielding Medicare’s 48 million current beneficiaries.

“You can’t reduce the deficit without making some people pay more or get less,” said Paul Van de Water, a senior analyst with the Center on Budget and Policy Priorities.