How’d you like to be a county executive, legislator or member of a board of supervisors and have to decide the future of a financially-troubled county-owned nursing home? Often one of the area’s major institutions and employers, it provides an important community service, even though typically costing the county taxpayers significant amounts of money. No matter what you decide, you’re likely to be criticized from one or more directions. That is the unpleasant reality currently being faced by public officials in counties throughout all regions of New York State.
As recently as 2005, more than 40 counties outside New York City owned and operated public nursing homes containing some 9,900 beds. Now those numbers are closer to 35 counties and 8,100 beds, and those totals are likely to dwindle further over the next few years. Why the sharp declines in such a short period of time? Rising costs and declining revenues combine to force county taxpayers to plug steadily-rising deficits. Read more »
The financial problems of the nation and many large states—California, Illinois, New Jersey and certainly New York—present a problem that is challenging economically and hazardous politically. Since it’s impossible to separate the economics from the politics, it is truly a Gordian knot – rather than untying the knot, Alexander the Great sliced the Gordian knot in two with a single, bold stroke of his sword.
The Congressional Budget Office forecasts the federal deficit to decline from about $1.5 trillion in 2009 to $608 billion in 2014, then rise to nearly $800 billion in 2020. This is a hefty deficit, particularly when you consider that we had a surplus as recently as 2000. Then consider that the cumulative public debt, which currently stands at $7.5 trillion, is expected to nearly double by 2020 to $14 trillion.
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Congress is edging closer to passing legislation that restructures health insurance. The Senate and the House are debating compromise bills within their houses, after which a conference committee will seek to reconcile differences between them. With these details still under debate, we conclude our six part series on health reform with a few observations.
Public Option. If private insurance plans are part of the problem, then one solution may be to offer another option, a health insurance plan that is run by the government. At this writing, a “public option” seems likely to survive and become part of the final legislation. The debate over the public option has highlighted a fundamental social tension between those who fear too much government and those who fear too little (discussed in the first column in this series). Like Goldilocks, each of us wants the balance to be “just right.”
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