Local government in the rest of the state(especially school districts ), rich pensions for those cashing in and moving out, special tax deals -- and debts run up to pay for it all while disguising the cost are each as important in terms of extra spending as a share of personal income with questionable value in return.

Medicaid may be a bigger monster, but the rest of the country pays for part of it, though we are probably screwed over in other categories of federal spending in return.

What isn't the monster --minorities, the poor, immigrants, the young and others living in NYC. That isn't where it is going.