Category: News and Opinion

Checking in with the Centers for Medicare and Medicaid datamart, I find that all the states have now reported Medicaid information for 2004. In fact a few, including New York State, have already reported data for 2005. Now I am at least able to fully tabulate Medicaid spending by type of service for 2004, and the overall bottom lines are these. New York State’s spending per Medicaid beneficiary was $7,910, 70.4% above the national average and 23.7% higher than the average of surrounding states (PA, NJ, CT, MA, VT). With 6.6% of the nation’s population, New York accounted for 8.5% of its Medicaid beneficiaries, a difference only partially explained by the state’s above average poverty and elderly population. New York State residents accounted for 7.6% of U.S. personal income in 2004, according the Bureau of Economic Analysis, and 8.6% of national earnings in the Health Care and Social Assistance industries. The state, however, accounted for 14.5% of national Medicaid expenditures that year. The details by type of service are in the attached spreadsheet, and are described following the break.

Now that the Steamroller has been shown that it may be necessary to remove some of the base course before a road’s surface course can be smoothed over, I’ve downloaded some detailed annual average data for 2005 to show why New York’s health care industry is so expensive. As I showed in this post – it isn’t because most health care workers, aside from hospital and nursing home workers represented by Local 1199 and perhaps some top administrators, are overpaid once the cost of living and overall wage levels are adjusted for. They are by and large either fairly paid (nurses) or underpaid (physicians, home care workers). The problem is there are so many of them in particular categories and, perhaps, in New York Medicaid is paying for services for the non-poor that elsewhere others do without or pay for themselves.

Perhaps familiarity breeds contempt, and perhaps I’ve been too hard on them, but it appears that not everyone shares the dim view of New York State Assembly Speaker Sheldon Silver and New York State Senate Majority Leader Joseph Bruno that most editorial boards, think tanks, and blog posters in New York State have. While researching for another post I came upon a press release from the National Conference of State Legislatures. Evidently, Silver and Bruno will be honored for their exemplary work at the group’s Annual Meeting in Boston August 5th to 9th. The press release cites the recent improvement in the way the legislature operates, including two on-time budgets in a row (now three), along with their “commitment to democracy, sound public policy, and an efficient legislative process.” The group’s website is here http://www.ncsl.org/, but if you have trouble finding the press release I have additional florid praise after the break. All I can say is take this with a grain of salt: this is an organization of and for state legislators and their staffs, and may have just wanted to do the two men of the room a favor in the wake of the Brennan Center report and other indignities.

The New York State Department of Labor has released Current Employment Survey data for February, and it seems various publicly funded entities around the state pretty much figured what the state budget would bring. New York City's local government cut another 1,600 jobs over the year to February 2007, while the state as a whole added 6,300, meaning the rest of the state added 7,900. In New York City, meanwhile, home health care employment rose by 5,400 from February 2006 to February 2007, and hospitals added 1,300 dues payers and campaign contributors. Er, service providers.

All I want to know is this. Last year NYC received 37% of state school aid plus back door school aid such as STAR. Including Spitzer's new checks, what will the share be this year? Spitzer's proposal was 37% for NYC, same as last year, and 14.1% for Long Island, same as last year. If those figures change, that should be the only story. THE ONLY STORY. The rest is PR.

Remember, NYC residents pay more than 40% of all state taxes paid by state residents. Forget the city's share of business taxes. After 30 years of harm to New York City's children, Governor Spitzer proposed that New York City's taxpayers would be required to pay more for education in NYC, and also have more money redistributed to the rest of the state, where the children are better off.

The New York Times had an interesting article about a month ago. The newspaper reported that for the first time since the Great Depression, senior citizens over age 75 are relocating from the South, from places like Florida, to the North, to places like New York “after losing spouses or becoming less mobile.” The migration means that seniors can avoid paying high New York taxes when they are healthy and wealthy, and then come back and claim New York’s more ample senior benefits, when they grow wise enough to see the value of extensive public services.

As one demographer put it “the South, and Florida especially, has been a magnet for yuppie elderly: younger seniors with spouse present and in good health. These are a catch for communities that receive them, because they have ample disposable incomes and make few demands on public services.” On the other hand, “the older senior population, especially after 80, are more likely to be widowed, less well off and more in need of social and economic support.” By not providing that support, states like Florida and Arizona take the money and dump the costs back to New York and the Midwest, where the federal share of Medicaid is low. “Many northern states seem to have better senior services than Florida,” that demographer told the Times.

In its ongoing effort to preserve an unjust state education finance system, the State Senate must rely on deception, because under no set of consistent principles would New York City receive even the level of state education funding Governor Spitzer has proposed, let alone what it has received in the past. If the State Senate accepts that places whose children have greater needs deserve a higher share of state school aid, New York deserves more. But if argues that better off places deserve more money based on the share of state taxes they pay in, New York City also deserves more. If it argues that those with high taxes deserve more aid, New York City, among the highest-taxed parts of the state, still deserves more. And if it continues to hold that whoever spends the most deserves more state aid, through back-door aid like STAR, then it is hardly adhering to purported Republican principles. In any event, Governor Spitzer hasn’t proposed giving NYC more money as a share of the total; the State Senate is demanding that it receive less money. So to justify the unjustifiable, the State Senate endlessly repeats two deceptions, but last week let slip a truth.