American Character Is at Stake
...In 1960, entitlement payments accounted for well under a third of the federal government's total outlays—about the same fraction as in 1940, when the Great Depression was still shaping American life. But over subsequent decades, entitlements as a percentage of total federal spending soared. By 2010 they accounted for just about two-thirds of all federal spending, with all other responsibilities of the federal government making up barely one-third. In a very real sense, entitlements have turned American governance upside-down....

...Poverty- or income-related entitlements—transfers of money, goods or services, including health-care services—accounted for over $650 billion in government outlays in 2010. Between 1960 and 2010, inflation-adjusted transfers for these objectives increased by over 30-fold, or by over 7% a year. Significantly, however, income and benefit transfers associated with traditional safety-net programs comprised only about a third of entitlements granted on income status, with two-thirds of those allocations absorbed by the health-care guarantees offered through the Medicaid program.

For their part, entitlements for older Americans—Medicare, Social Security and other pension payments—worked out to even more by 2010, about $1.2 trillion. In real terms, these transfers multiplied by a factor of about 12 over that period—or an average growth of more than 5% a year. But in purely arithmetic terms, the most astonishing growth of entitlements has been for health-care guarantees based on claims of age (Medicare) or income (Medicaid). Until the mid-1960s, no such entitlements existed; by 2010, these two programs were absorbing more than $900 billion annually....