Health Care

At the end of an interesting and data-packed post on the growth in federal spending, Nate Silver offers a hypothesis:

bq. Nevertheless, the declining level of trust in government since the 1970s is a fairly close mirror for the growth in spending on social insurance as a share of the gross domestic product and of overall government expenditures. We may have gone from conceiving of government as an entity that builds roads, dams and airports, provides shared services like schooling, policing and national parks, and wages wars, into the world’s largest insurance broker.

bq. Most of us don’t much care for our insurance broker.

Nate suggests that the growth in spending on social insurance is changing what goverment does and perhaps making people trust the government less. The former is undoubtedly true. I am more skeptical about the latter. Here is why.

Nate looks at the growth in entitlements as a percent of GDP, and categorizes spending on health care, education, and welfare as entitlements. (The data are available here.) I think I’ve adequately replicated the trend he documents, though focusing on the period from 1958-2011.

And now the trend in trust in the federal government. This is the percentage who say that you can trust the “government in Washington” “just about always” or “most of the time,” using data from the American National Election Studies, supplemented with an October 2006 CBS News poll. (Adding more data from public polls would show the same trend.)

The two trends don’t appear to square that well. Entitlement spending increases consistently, if not linearly. But trust in government has important peaks and valleys. It hasn’t simply declined since the 1970s.

What happens if we plot the relationship for those years were we have both sets of data?

Using all the data, 1958-2008, there is a negative correlation: more entitlement spending coincides with lower trust in government. But this relationship leans heavily on the period from 1958-1972 (or 1958-1974 or 1958-1976 — you can cut the data a couple different ways and get the same finding). Once we focus on the period from 1974 onward, there is no meaningful correlation. This is despite the fact that entitlement spending increased from 9.5% of GDP in 1974 to 15.7% in 2008. So a lot depends on how you want to interpret the decline from 1964-1972 or thereabouts. Entitlement spending did increase during this time — it nearly doubled — but there were also an economic slowdown, the Vietnam War, and Watergate.

Of course, these data don’t speak to the more subtle question of whether popular conceptions of government have changed as government has devoted more resources to entitlements. That said, it’s also worth mentioning that entitlement programs like Social Security and Medicare are among the most popular (though less so Medicaid and welfare, obviously). People may not care for their insurance broker, but they do seem to like government insurance.

[Full disclosure: I have been an occasional contributor to the 538 blog.]