WASHINGTON (AP) — President Barack Obama and Republican rival Mitt Romney agree there has to be a limit to how much seniors pay for Medicare, but they're worlds apart on how to make that happen.

You wouldn't know it from the accusations they hurl on the campaign trail, but that is the real heart of the argument between the two leaders and their political parties.

There will be consequences for seniors and the nation's health care industry no matter which way the debate is decided, because both sides agree Medicare spending must be controlled.

Obama relies heavily on cutting payments, the amount hospitals might get for a heart bypass or how much a radiologist is reimbursed for reading an MRI.

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