Tag Archives: New York City Health and Hospitals Corporation

Health Care: 2017 Census of Governments Data

Many New Yorkers were stunned when Mayor Bill DeBlasio announced that the New York City Health and Hospitals Corporation, which runs public hospitals in the city, rather than the legendary New York City Health Department, would take the lead on testing and contact tracing as the city attempts to emerge from the COVID-19 pandemic.

“It makes absolutely no sense to move a function that has been done well by a great health department for decades to an organization that does not have the legal, epidemiologic, administrative or technical experience to manage it,” said Dr. Tom Frieden, a former city health commissioner and former director of the Centers for Disease Control and Prevention.

Perhaps Mayor DeBlasio knows something that the Times and Dr. Frieden do not.  That when measured per $1,000 of the personal income of all city residents, the Department of Health doesn’t have as much funding as it did back when former Mayor Bloomberg was nagging us about our health. That is one of the findings of an analysis of state and local government Health, Hospitals and Medicaid Vendor Payment expenditures, and the jointly funded federal and state (and in NY local) government Medicaid program that is used to pay for most of them.

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Hospitals, Social Services, and Housing: Census of Governments Employment and Payroll Data for 2017

Health care vies with elementary and secondary education as the largest destination for federal and state government spending.  In fact, when I added it up in 2006 the federal, state and local governments were already paying for 75.0% to 80.0% of third party (insurance and public program) health care expenditures nationwide, which is to say expenditures other than co-payments and services people pay for themselves in cash (such as cosmetic surgery).  Directly (Medicare, Medicaid, the VA Hospital system) or indirectly (health insurance purchased on behalf of civilian public employees and their families, the exclusion of employer funded health insurance from taxable income, other tax breaks).

Socialized Medicine? Get Real, It’s Already Here

Since then the population has aged, leading to more Medicare and Medicaid spending, Medicaid has been expanded to more working people, and Obamacare has added another form of indirect federal support for private health insurance.  For all the discussion of “socialized medicine,” here in the U.S. the government share of third party health care expenditures is probably up to 85.0% or so, and as a percent of GDP it probably exceeds the cost of the entire health care system in developed countries.

Health care and social services, however, are provided by the government primarily through payments to private sector organizations, generally non-profits in New York City and throughout the Northeast.  Therefore in this, the fifth post based on my tabulation of state and local government employment and payroll data from the 2017 Census of Governments, data on related private sector organizations from the Bureau of Labor Statistics will take center stage.   And this analysis features the most shocking trend I have found so far.

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