Peter Ferrara
As in so much else, Progressives hold an outdated conception of the debate over entitlements. They conceive it as the Left supporting generous entitlements for seniors and the poor with no questions asked, no obligations expected, versus the right supporting no safety net at all, let private charity handle it, and if some of the poor have to starve, and some of the sick suffer or die without health care, because private charity is inadequate, so be it.

But modern, free market conservatives have built on Hayek's recognition that social safety nets are not inconsistent with free markets, and just reflect modern social responsibility. Free market conservatives today are advancing fundamental entitlement reforms that would actually serve seniors and the poor far better than today's outdated entitlement programs based on old fashioned, 19th century, tax and spend conceptions. These free market safety nets would be based on market competition, incentives, and individual choice. They would rely primarily on modern capital and labor markets to achieve their goals far more effectively. Their incentives would promote productive behavior that contributes to rather than detracts from economic growth and prosperity for all.

A case in point is Medicaid, the national entitlement program for the poor, to ensure that no one suffers without essential health care due to lack of money. That was one focus of the Presidential debate between Obama and Romney this week, in which Romney again thoroughly flummoxed an uninformed Obama, lost deep in the last century. That program is also a central component of the entitlement problem threatening to bankrupt the nation.

Financing for the program is shared with the states under a federal formula, with the Feds paying about 60% of the costs on average. That is a matching federal formula, with the feds sending more federal money to a state the more the state spends on the program. President Obama's budget projects federal Medicaid costs to total nearly $4.4 trillion over the next 10 years alone, just for this one program, with annual costs soaring by 127% over that time to nearly $600 billion by 2022.

The state costs would run roughly an additional two-thirds more. The National Association of State Budget Officers reports that states already spend more on Medicaid than anything else - even K-12 education programs. The federal Center for Medicare and Medicaid Services projects that total federal and state costs just for Medicaid alone will be over $800 billion by 2019.

Peter Ferrara

Peter Ferrara is a senior fellow at the National Center for Policy Analysis and a Senior Fellow at the Heartland Institute.