John C. Goodman

So who is to blame for this state of affairs? Lyndon Johnson, of course, gave us Medicare, Medicaid and the rest of the Great Society. But when Johnson left office, these programs were relatively small. The main expansion came under Republican presidents Richard Nixon and Gerald Ford. Not only that, the expansions were largely the result of executive orders! That is, they didn't have to happen.

The growth of the entitlement state moderated somewhat under presidents Carter, Reagan, and George H.W. Bush. Because of welfare reform under Bill Clinton, there was actually the prospect of some contraction. But during the presidency of George W. Bush, Republicans pushed for a new drug benefit under Medicare with a huge unfunded liability — greater in fact than the unfunded liability under Social Security.

Eberstadt summarizes the past 50 years this way:

From a purely statistical standpoint, the growth of entitlement spending over the past half-century has been distinctly greater under Republican administrations than Democratic ones. Between 1960 and 2010, the growth of entitlement spending was exponential, but in any given year, it was on the whole roughly 8% higher if the president happened to be a Republican rather than a Democrat.

Of course, the past may not repeat itself. We may have entered a new era. Barack Obama is the first Democratic president since Lyndon Johnson to call for a larger entitlement state — especially with the enactment of ObamaCare. Further, Republican nominee Mitt Romney has pledged to repeal ObamaCare as soon as he is elected.

Still, it's worth remembering past deeds in addition to words. If Republicans succeed in electing the Romney/Ryan ticket, let's hope they don't suffer buyer's remorse.


John C. Goodman

John C. Goodman is Senior Fellow at The Independent Institute and author of the widely acclaimed book, Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts."