In fall of 2017 I started a new position as manager of external affairs for the Hoover Institution’s Washington, D.C. office. A primary function of the D.C. office is to, “promote the academic work of Hoover fellows and to facilitate the engagement of fellows in the policy conversations that take place in the nation’s capital.” To a large extent, this involves hosting Hoover fellows from California, and on November 1, 2017 the first fellow we hosted in my tenure with the organization was John F. Cogan, the author of The High Cost of Good Intentions: A History of U.S. Federal Entitlement Programs. It took me a while to read the book, but quality time flying across the country for my first visit to Stanford University in an official capacity was the perfect setting to accomplish the bulk of the reading. (It’s fitting that I finished the first book I received on the job during the flight for my first visit to the main office, but if we’re being honest, I really should have finished the book a few months ago – no judging please!)

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The book’s central theme is that the creation of entitlements brings forth relentless forces that cause them to inexorably expand.

The book is a nearly 400 page read (not including notes/citations) offering a comprehensive history of federal entitlement programs. Dr. Cogan begins with the first major federal entitlements, benefit programs for disabled wartime veterans, and covers the long history of federal entitlements, including the advent of well-known Social rSecurity, Medicare, Medicaid, and culminating with the passage of the Affordable Care Act (personally, my least favorite legislation). “The High Cost of Good Intentions” is a fitting title for the book. “The book’s central theme is that the creation of entitlements brings forth relentless forces that cause them to inexorably expand.” (Cogan, p. 4) As Cogan illustrates, the tendency of an entitlement program, with the blessing of policymakers, is to liberalize and expand to populations beyond the original intent of the program. Only rarely are these programs retrenched and on rarer occasions were entitlements eliminated.

This is a recommended read for anyone with a mind toward history, policy, and solving the problem of fiscal sustainability. The United States’ long-term fiscal challenges are driven by entitlement spending and solutions need to involve the major entitlement programs that constitute ever growing shares of spending. Attempts to reform entitlement spending will benefit from the historical lessons illustrated in this book.