Increasing the Effectiveness and Sustainability of the Nation’s Entitlement Programs

The United States faces a large and growing fiscal challenge that is being ignored by most of the nation’s policymakers. The Congressional Budget Office (CBO) projects that debt held by the public will reach 100 percent of gross domestic product (GDP) in 2039.

The primary cause of the problem is the steady, decades-long rise in entitlement spending. Over the past 75 years, the United States has built a vast and sprawling network of social welfare protections and programs—the entitlement state. These programs’ cumulative costs now threaten to push the federal government past the point of insolvency.

However, it is insufficient to base a push for reform on a fiscal rationale alone. Reforms must be—and must be understood by the public as—good ideas that improve the programs’ effectiveness and efficiency, separate and apart from budgetary effects. Although entitlement programs vary greatly in their roles and design, the important themes for reform should be: promotion of work, personal responsibility, and innovation and high quality in health care.

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