When I was in Austin, Texas, last week, I took the opportunity to visit the Lyndon Baines Johnson Presidential Library on the University of Texas campus. The library is housed in a beautiful building with impressive resources. Its employees and volunteers are gracious and welcoming. I thoroughly enjoyed the exhibits (especially those devoted to the contributions of LBJ's lovely and accomplished wife, Lady Bird Johnson).
And yet, I came away from my visit profoundly sad.
LBJ's legacy is a complicated one. As John F. Kennedy's vice president, Johnson was thrust into the presidency by Kennedy's assassination in Dallas on Nov. 22, 1963. President Johnson's speech to the nation just five days later is considered one of the finest of his career. (He began with the somber words, "All I have, I would have given gladly not to be standing here today.") Even so, Johnson viewed Kennedy's death as an opportunity for self-aggrandizement and to push his own agenda. "I am a Roosevelt New Dealer," Johnson said the day after the assassination. "Kennedy was a little too conservative to suit my taste."
Johnson was a vehement and vocal racist, yet considered a civil rights hero for passage of the Civil Rights Act of 1964 and a barrage of other legislation advancing social programs as part of his Great Society policy initiatives, modeled after the New Deal of Depression-era President Franklin D. Roosevelt.
But if history has (for the most part) been kind to FDR, the same cannot be said of LBJ.
The mistakes and failures of the Great Society programs continue to rack up. Health care policy analyst Sally Pipes provided sobering statistics in an article for Forbes magazine last year. Two years after Medicare was launched in 1965, the House Ways and Means Committee forecast that Medicare spending would be $12 billion by 1990; the actual figure was $110 billion. Last year, Medicare spending was $875 billion, with approximately 62 million people enrolled. That number is expected to be nearly 80 million by 2030, at which point Medicare spending will be well over $1 trillion.
Medicaid has had a similar trajectory. It cost taxpayers $3 billion in 1967, when slightly less than 4% of the U.S. population was enrolled. As of February 2022, 87 million people were receiving Medicaid or CHIP (Children's Health Insurance Program) benefits – 26% of the population, or more than one in every four Americans. Medicaid spending in 2021 was $696 billion. Of that, $86 billion (that we know of) was squandered on fraud or other "improper payments."
Regrettably, these programs have failed to achieve their stated objectives. The Heritage Foundation published a report on the 50th anniversary of Johnson's "Great Society" speech. Data shows that poverty rates dropped dramatically between the end of World War II and 1964. And yet, despite expenditures of more than $22 trillion since 1964, the poverty rate has consistently remained between 12% and 15%.
The data on health outcomes is not much more encouraging.
One of the most distressing aspects of the COVID-19 pandemic was its disproportionate impact on obese people, who were, according to a 2020 study published in Obesity Reviews, "113% more likely than people of healthy weight to land in the hospital, 74% more likely to be admitted to an ICU, and 48% more likely to die." But even before COVID, obesity's toll on Americans' health was staggering; the Centers for Disease Control and Prevention reports that health care costs associated with obesity-related illness are more than $170 billion a year and rising.
The hundreds of billions being spent annually on Medicare and Medicaid have not made a dent. Quite the contrary. The percentage of obese adults in the early 1960s, prior to the passage of Johnson's Great Society programs, was just 13%. Among children, it was only 5%. Today, 42% of American adults are obese (up from 30.5% as recently as 1999). And according to the journal Global Pediatric Health, obesity has doubled in children and tripled in adolescents since 1990. Furthermore, there is a strong (and unusual) correlation between poverty and obesity in the U.S. An article published in 2011 in the journal of the American Diabetes Association states, "In contrast to international trends, people in America who live in the most poverty-dense counties are those most prone to obesity."
The welfare state created by Johnson's Great Society programs has had an outsized negative effect on America's black population as well. Black economist and bestselling author Thomas Sowell has written about this extensively. In 2014, Sowell responded to New York Times' writer Nicholas Kristof, who attributed the economic struggles of U.S. blacks to the legacy of racism.
Sowell, who grew up in poverty, disagrees. In his column, "A legacy of liberalism," he wrote:
Despite the grand myth that black economic progress began or accelerated with the passage of the civil rights laws and 'war on poverty' programs of the 1960s, the cold fact is that the poverty rate among blacks fell from 87 percent in 1940 to 47 percent by 1960. This was before any of those programs began. ... Nearly a hundred years of the supposed 'legacy of slavery' found most black children being raised in two-parent families in 1960. But thirty years after the liberal welfare state found the great majority of black children being raised by a single parent. ... The murder rate among blacks in 1960 was one-half of what it became 20 years later, after a legacy of liberals' law enforcement policies.
As one might expect, the exhibits at the LBJ Presidential Library focus more on the magnitude of the challenges Johnson faced and his deep humanitarian intentions than on the consequences of his Great Society initiatives. But Americans must evaluate the results – and costs – of political programs with eyes unclouded by sentiment or nostalgia.
We continue to suffer the consequences of the misguided policies of the 1960s. Johnson may have had ignorance as an excuse. Almost 60 years later, we do not.