It’s Official: Uncle Sam Is a Health Care Program with an Army

Health spending is now the largest category.

Over at The HillBernie Becker notes that, according to a July report by the Congressional Budget Office, “Medicare, Medicaid, and other healthcare programs are projected to surpass Social Security in costs in 2015.”

The lines are finally crossing. For decades, Social Security has been the largest spending program, followed by National Defense and Medicare. But now, when you add the various federal health care programs together, health care as a category is number one.

Social Security currently consumes about 25 percent of the budget. Medicare, Medicaid, and Obamacare, together, consume about 25 percent. National Defense consumes a little under 20 percent. But health care is growing faster than everything else. So it’s official. We have a health care program with an army. And that will remain the case for a long time.

What, if anything, should we do about it? Given our massive debt and chronic deficits, we really have no choice. We have to reduce federal health spending. Big time. The only question is how.

Ideally, we’d devolve all federal health care spending to the states and the private sector, in conformity with the Constitution. (Devolution means eliminating programs and taxes simultaneously, by the same amount.) Short of that, we should reduce benefits and eligibility for health care entitlements.

But before doing that, I think we should make all federal welfare programs (especially Medicare and Obamacare) optional for individuals and put recipients in charge of their own purchasing decisions (as, for example, by giving seniors and other Americans access to Health Savings Accounts). Start with freedom and choice. It makes the castor oil easier to swallow.

I’ve written elsewhere about how best to reduce Medicare spending, why we should block-grant Obamacare, and how to fix health care in three easy steps.

Until we get serious about health care spending, Uncle Sam will remain a health care program with an army.

Dean Clancy, a former senior official in the White House and Congress, writes on U.S. budget, health care, and constitutional issues. Follow him at or on twitter @deanclancy.


One Reply to “It’s Official: Uncle Sam Is a Health Care Program with an Army”

  1. Trying not to be snarky but I get why “some” Members of Congress in Florida are fearful of going against this army to #FULLREPEAL what Tara Setmeyer once called #ObamacareHell. They are terrified of not getting re-elected vs doing what is right and letting the consequences follow.

    Making all Welfare Programs optional is a slow start but not bad as long as Congress moves rapidly towards getting Government completely out of all Health & Welfare schemes. …. of course all said IMHO.

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