Are Long Term Budget Issues a "Lost Cause"?

One can't help but wonder, whether we might as well call it a day re the national budget outlook, given the news of Paul Ryan's upcoming early retirement. The WSJ notes that once he leaves, the Republican party will lose its "most influential advocate for changes to Social Security, Medicare and Medicaid":

Mr. Ryan will leave Congress with no substantial progress on any of them, few lawmakers interested in picking up the torch, and a clear signal that prospects are dim for any big overhaul in the foreseeable future.

Indeed, Donald Trump also made it clear early on, that he did not want substantial reductions in either retirement or health benefits. He's certainly not alone.

I have mixed feelings about Ryan's wished for legacy, since - given the chance - he might have slashed budgets in ways that generated austerity with no proactive response from healthcare suppliers in the private sector. Just the same, he was one of the few in Washington who recognized what was at stake, for long term budgetary issues. Meanwhile the basic problem remains: Everything about Medicare and Medicaid in particular, was a band-aid attempt to make amends for private sector shortcomings - many of which surfaced well over a century earlier. Thus far, no constructive dialogue has taken place in Washington, re healthcare's contribution to budgetary woes. No one is on the same page, in spite of similar policy recommendations which seem to resurface time and again.

Also, according to the WSJ,

The trust fund for Medicare that supports hospital spending for older Americans is currently projected to be depleted in 2029. 

It's easy to forget that the problems rural areas have experienced re healthcare access in recent decades, might surface in city healthcare systems as well - possibly even within the course of my lifetime. Even though baby boomers such as myself attempt to avoid doctors and hospitals wherever possible, many people simply don't have the option of doing so. What's more, the fact some of us often manage to avoid doctor's offices for the better part of a decade, isn't enough to help the budgetary problems that healthcare has created for our government.

Let's give citizens permission, to find better means by which they can take care of themselves. People deserve the right to practice healing as a part of this process, and everyone deserves permission to tap into the vast amount of practical and experiential assistance made possible by the digital era. Production reform is sorely needed, not just for those who lack access to formal healthcare, but also so that governments won't implode from too many self imposed responsibilities. John C. Williams of the San Francisco Fed recently voiced his concerns re Washington's budgetary dilemma, as well:

The federal government, by anybody's measure, is on an unsustainable path in terms of deficits and debt accumulation over the next 30-40 years. This is not a secret...It's gotten a little bit worse as fiscal stimulus comes in and makes the deficit go somewhat bigger in the next 5 to 10 years. But the underlying problem was there already. And so the concerns that I have are not so much some kind of crisis...I'm not that worried about markets reacting to this. It's more about how do we make sure that we have solutions for Medicare, Social Security, and other government programs, and get us somehow back on a more sustainable path.