Medicaid Expenditures: Up or Down?
New York’s powerful and advantaged interests like to compare this year’s spending with last year’s spending. This locks in the winners and losers, by making the privileges of the past the baseline for the future. I like to compare revenues, expenditures, employment and pay between places as well, to identify who the advantaged interests are. I also try to adjust for factors that might explain, and justify, any differences. But when the health care industry told the New York Times that Medicaid spending per beneficiary has been going down since 2000, and cited the Center of Medicare and Medicaid as a source, I decided to check my spreadsheets. I get total New York Medicaid expenditures per beneficiary at $7,646 in 2000 and $7,910 in 2004, a 3.5% gain. For Hospital services, spending per beneficiary rose from $7,861 to $8,364, a 6.4% increase. And for Nursing Home services for the aged, spending rose from $35,187 to $43,957, a 22.1% rise. In the latter two cases, I do not believe the funds that are part of the 2002 Health Care Reform Act are included, since these do not concern the federal government. That said, these are smaller gains than these industries are used to ordering people to provide. But they still aren’t losses. Perhaps the health care industry provided data based on expenditures divided by the number enrolled in Medicaid, whether or not they needed any health care. The Times should not have swallowed what they were told whole.
In fact, everyone should assume that any information provided by anyone with a direct financial stake in public policy, or funded by those with such a stake, is partial and misleading at best, deceptive at worst. That is what I have found to be the case, and not just with regards the propaganda machine at the Greater New York Hospital Association and Local 1199. That's why I'm glad to be able to post comprehensive, sourced spreadsheets here on Room Eight. I have no idea how many people download, look at, and think about them, but at least I'm trying to do my part.
This may sound like a particularly bleak assessment, but there aren't a lot of organizations willing to pay college graduates to tell the truth, nothing but the truth, AND the whole truth, in either the public or private sector. That doesn't pay. In fact, sometimes I wonder how long accurate data will be readily available even for those who aren't too lazy to download and compile it themselves. America's public bean counters: disparaged as "useless bureaucrats," at least I admire and respect your work.
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