This is not a problem specific to Paul Ryan, but it always strikes me as absurd that it's considered the very height of Washington, D.C., seriousness to pay lots of attention to 75-year budget projections. Look at that chart and roll it backward in time to the year 1940. Europe is at war, and the United States is clearly casting its lot with the United Kingdom but not directly involved on a military level. People are wondering if tough economic sanctions on Japan will be enough to dissuade it from its brutal efforts to conquer China. There are no antibiotics, jet planes, or television networks. Somebody tells you he has an idea about changing federal health care policy. You ask him, as if it's the most natural question in the world, "What are the implications of your proposal for the federal budget in the year 2012?"
He sits down at a desk with his slide rule to try to figure it out. If he's lucky, the calculation has a high priority and he'll have the budget necessary to hire some human computers to assist him with the calculations. He's of course going to miss the invention of the nuclear weapons, the Iron Curtain across Europe, and a decades-long Cold War, but perhaps it's not such a big deal because of course by 2012 the Cold War will be over and the Iron Curtain torn down. Little does he know that in 2009 there will be a furious debate about the implications of digital medical records for long-term health care costs because at the time of his work there are no digital records of anything.
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