The most recent 24 hour news cycle obsession, THE GOVERNMENT SHUTDOWN, came and went with the ultimate consequence still up in the air. The immediate consequence, the Cherry Blossom Parade completing the fully planned route, was a good outcome for those who were in DC. The long-term outcome may have far-reaching negative consequences to the most vulnerable of our society.

The American public, or at least a vocal subset, has spoken out against continued “unchecked” spending. That subset demanded reductions in spending which seem to have been granted as a result of the recently completed negotiations. The news cycle seems to have distorted the American public’s perception of the budget and the consequences of the “largest reduction in federal spending ever.” 40% of the public believe that NPR accounts for 5% of the federal budget, not the 0.00014% that it actually does, and as such no doubt believe that the crisis will be over following the closure of the stations. The news outlets continue to carry the “outcry” for more draconian actions that would seem counter to the interest of the population.

Congressman Paul Ryan seems to be the latest darling of the news cycle. He has declared that ACA will bankrupt the country and has a budget plan that (in the words of The Atlantic):

In a nutshell, Ryancare phases out Medicare to expose consumers to the true costs of health care. Under Ryancare, the government would send seniors a voucher equal to the amount that we’re projected to pay for the typical Medicare recipient in 2022. Every year after 2022, the voucher’s value would increase at the pace of the consumer price index — considerably slower than the typical growth of health care spending. As government pays for a smaller share of health care, families will bear greater exposure to health costs. Conservatives hope that if we expose patients to the true costs of health care expenses, they’ll be more frugal about treatments.

As the New Republic points out, we already have a plan that will slow the growth of health care without putting frail elderly at risk of premature, painful death:

The Affordable Care Act’s central hope is that Medicare can lead the health-care system to pay for value, cut down on overtreatment, and cut out treatments that simply don’t work. The law develops Accountable Care Organizations, in which Medicare pays one provider to coordinate all of your care successfully, rather than paying many doctors and providers to add to your care no matter the cost or outcome, as is the current practice. It also begins experimenting with bundled payments, in which Medicare pays one lump-sum for all care related to the successful treatment of a condition rather than paying for every piece of care separately. To help these reforms succeed, and to help all doctors make more cost-effective treatment decisions, the law accelerates research on which drugs and treatments are most effective, and creates and funds the Patient-Centered Outcomes Research Institute to disseminate the data.

And, as the New England Journal of Medicine points out, the Congressman’s plan would lead to health care haves and have-nots on a very large scale in 40 short years

Although the Ryan–Rivlin and House Budget Committee plans are called “premium support,” they actually jettison all or most of the consumer protections that distinguish premium support from bare vouchers. Both would shift costs to Medicare enrollees. The CBO estimates that by 2030 the House Budget Committee plan would increase the out-of-pocket share of health care spending for a typical Medicare beneficiary from the current 25-to-30% range to 68%. By 2050, the House plan would cut federal health care spending by approximately two thirds.

The American public may be willing to let the NPR stations go silent in exchange for assurances that the country will continue to exist for a couple of more years. Congressman Ryan, or so the news accounts suggests, believes that for us to continue to exist as a country we are not going to be able to do what every other western country does:  provide health care for our citizens without regard to their ability to personally pay. His budget suggests that folks should be able to personally fund large portion of their health care or else allow receive care only if a non-governmental organization deems them worthy. This is consistent with the FreedomWorks vision for American health care but interestingly enough not consistent with the latest Kaiser poll.

There used to be a disclaimer on “Dear Abby” that the column is for entertainment purposes and should not be used for decision-making purposes. I hope to see such a disclaimer appear on certain media more frequently. Me, I get my news from NPR.