Tag: Albany

Society faces a dilemma.  It does not want to see children and the elderly suffer from the neglect of family members.  When it assumes the role of “family of last resort,” however, it encourages the selfish to shift family burdens onto the community, taxing those who meet such obligations to pay for it.  Concerns about burden shifting by parents led to the Welfare Reform Act of 1996, which cut them off from assistance after five years even at the risk of suffering by the children.  Yet the modest, and now miniscule, cost of welfare is dwarfed by the cost of custodial care for the elderly, and as the population ages that cost is set to explode, with consequences that dwarf those of baby boom retirement and the unfunded cost of Social Security.  This may be the most important financial issue we face as a society.   And for New York, which has more generous services for the elderly than any other state, it is a greater issue still.

Society faces a dilemma.  It does not want to see children and the elderly suffer from the neglect of family members.  When it assumes the role of “family of last resort,” however, it encourages the selfish to shift family burdens onto the community, taxing those who meet such obligations to pay for it.  Concerns about burden shifting by parents led to the Welfare Reform Act of 1996, which cut them off from assistance after five years even at the risk of suffering by the children.  Yet the modest, and now miniscule, cost of welfare is dwarfed by the cost of custodial care for the elderly, and as the population ages that cost is set to explode, with consequences that dwarf those of baby boom retirement and the unfunded cost of Social Security.  This may be the most important financial issue we face as a society.   And for New York, which has more generous services for the elderly than any other state, it is a greater issue still.

Society faces a dilemma.  It does not want to see children and the elderly suffer from the neglect of family members.  When it assumes the role of “family of last resort,” however, it encourages the selfish to shift family burdens onto the community, taxing those who meet such obligations to pay for it.  Concerns about burden shifting by parents led to the Welfare Reform Act of 1996, which cut them off from assistance after five years even at the risk of suffering by the children.  Yet the modest, and now miniscule, cost of welfare is dwarfed by the cost of custodial care for the elderly, and as the population ages that cost is set to explode, with consequences that dwarf those of baby boom retirement and the unfunded cost of Social Security.  This may be the most important financial issue we face as a society.   And for New York, which has more generous services for the elderly than any other state, it is a greater issue still.

Society faces a dilemma.  It does not want to see children and the elderly suffer from the neglect of family members.  When it assumes the role of “family of last resort,” however, it encourages the selfish to shift family burdens onto the community, taxing those who meet such obligations to pay for it.  Concerns about burden shifting by parents led to the Welfare Reform Act of 1996, which cut them off from assistance after five years even at the risk of suffering by the children.  Yet the modest, and now miniscule, cost of welfare is dwarfed by the cost of custodial care for the elderly, and as the population ages that cost is set to explode, with consequences that dwarf those of baby boom retirement and the unfunded cost of Social Security.  This may be the most important financial issue we face as a society.   And for New York, which has more generous services for the elderly than any other state, it is a greater issue still.

As I reported here, in 2003 New York State was charged $7,912 per Medicaid beneficiary, 76% higher than the national average of $4,487 and more than any other state.  This is not a surprise, as New York has had the highest Medicaid spending per recipient as far back as I have collected data.  And, I once read a paper that described New York State’s Medicaid program as being vastly more expensive than other states in the early 1970s, less than a decade after the program was created.  In fact, I saw a film on the Channel 25 “City Classics” program showing a press conference by former Mayor Abe Beame, who was bemoaning the fact that Medicaid spending was out of control and seeking to use city resources to combat fraud to stop it.  The state had no interest in doing so, Beame said, because it could simply force the city to pay.

As I reported here, in 2003 New York State was charged $7,912 per Medicaid beneficiary, 76% higher than the national average of $4,487 and more than any other state.  This is not a surprise, as New York has had the highest Medicaid spending per recipient as far back as I have collected data.  And, I once read a paper that described New York State’s Medicaid program as being vastly more expensive than other states in the early 1970s, less than a decade after the program was created.  In fact, I saw a film on the Channel 25 “City Classics” program showing a press conference by former Mayor Abe Beame, who was bemoaning the fact that Medicaid spending was out of control and seeking to use city resources to combat fraud to stop it.  The state had no interest in doing so, Beame said, because it could simply force the city to pay.

As I reported here, in 2003 New York State was charged $7,912 per Medicaid beneficiary, 76% higher than the national average of $4,487 and more than any other state.  This is not a surprise, as New York has had the highest Medicaid spending per recipient as far back as I have collected data.  And, I once read a paper that described New York State’s Medicaid program as being vastly more expensive than other states in the early 1970s, less than a decade after the program was created.  In fact, I saw a film on the Channel 25 “City Classics” program showing a press conference by former Mayor Abe Beame, who was bemoaning the fact that Medicaid spending was out of control and seeking to use city resources to combat fraud to stop it.  The state had no interest in doing so, Beame said, because it could simply force the city to pay.

As I reported here, in 2003 New York State was charged $7,912 per Medicaid beneficiary, 76% higher than the national average of $4,487 and more than any other state.  This is not a surprise, as New York has had the highest Medicaid spending per recipient as far back as I have collected data.  And, I once read a paper that described New York State’s Medicaid program as being vastly more expensive than other states in the early 1970s, less than a decade after the program was created.  In fact, I saw a film on the Channel 25 “City Classics” program showing a press conference by former Mayor Abe Beame, who was bemoaning the fact that Medicaid spending was out of control and seeking to use city resources to combat fraud to stop it.  The state had no interest in doing so, Beame said, because it could simply force the city to pay.

When asked at the end of the1974 season why he was replacing his general manager, the owner of the Houston Oilers football team replied “I gave him an unlimited budget, and he exceeded it!”  The same may be said of New York State’s Medicaid program.  Its budget is unlimited – its cost goes up by whatever it does every year, and taxes are raised and other services cut to make up the difference. Medicaid, along with debt service and pensions, get the first, second and third bites of the apple.  (Public schools in the portion of New York State outside New York City get the fourth.)  And when the cost of Medicaid is restrained, as in the mid-to-late 1990s, it is by reducing the number of beneficiaries who receive health care benefits, not by restraining the increase in what the health care industry decides to charge.  The number of people employed by that industry in New York, fueled in large part by government money, rises rapidly each and every year.  With just 6.5% of the nation’s population, New York State accounted for 15.1% of its Medicaid spending (see attached spreadsheet).

When asked at the end of the1974 season why he was replacing his general manager, the owner of the Houston Oilers football team replied “I gave him an unlimited budget, and he exceeded it!”  The same may be said of New York State’s Medicaid program.  Its budget is unlimited – its cost goes up by whatever it does every year, and taxes are raised and other services cut to make up the difference. Medicaid, along with debt service and pensions, get the first, second and third bites of the apple.  (Public schools in the portion of New York State outside New York City get the fourth.)  And when the cost of Medicaid is restrained, as in the mid-to-late 1990s, it is by reducing the number of beneficiaries who receive health care benefits, not by restraining the increase in what the health care industry decides to charge.  The number of people employed by that industry in New York, fueled in large part by government money, rises rapidly each and every year.  With just 6.5% of the nation’s population, New York State accounted for 15.1% of its Medicaid spending (see attached spreadsheet).