The following appeared on Monday, October 5, 2020 on The Island Now’s website:

Time and again Gov. Andrew Cuomo has pledged to root out structural waste and inefficiencies in state government in general and, in particular, Medicaid.

In his 2010 book, “The New N.Y. Agenda: A Plan for Action,” Cuomo noted in a section titled “Make Medicaid More Efficient”:

“New York will spend almost $52 billion on Medicaid in 2010-11, including federal, state and local funding. State operating funds spending on Medicaid is projected to grow by another $1.8 billion in the 2011-12 fiscal year. New York must find a way to bring its Medicaid costs more in line with that of other states if we are to control overall state spending. New York state spends 69 percent more per beneficiary than the national average. New York’s Medicaid program suffers from spiraling costs, inadequate outcomes and widespread inefficiency.”

He added: “We need fundamental restructuring of Medicaid that looks to achieve long-term efficiencies and focuses on services that actually improve the health outcomes of New Yorkers.”

After 10 years in office, however, it doesn’t appear the governor has made much progress in taming the Medicaid leviathan.

In 2011, with 6 percent of the nation’s population, New York consumed 23 percent of the nation’s Medicaid spending. “By 2016,” Bill Hammond of the Empire Center for Public Policy, has reported, “New York had surged to 40 percent — and its spending has more than doubled since then.”

Total Medicaid spending for the state’s 2020-2021 fiscal year is projected to hit $80.3 billion.

That’s up 63 percent since 2010, well above the rate of inflation.

Granted, some of the growth is due to the COVID pandemic. However, hair-raising audits released by state Comptroller Tom DiNapoli’s office in September, indicate there is plenty of mismanagement, fraud and inefficiencies.

The DiNapoli audits found more than $700 million in unnecessary costs and overpayments. Here’s a summary of the findings:

The state’s Department of Health has not developed “sufficient controls and oversight to ensure the most effective delivery of pharmacy services under managed care.” The DOH failed to procure the lowest net cost drugs. By failing to establish proper procedures, the auditors estimated that between Jan. 1, 2016 and Dec. 31, 2019, $605 million was squandered on unnecessary drug costs.

Due to the failure to track Medicaid recipients who had multiple Client Identification Numbers (CIN) assigned to them, there were duplication of payments. The audit “found DOH made $47.8 million in improper payments on behalf of recipients with multiple CINs for the period Jan. 1, 2014 through March 31, 2019.”

The transmission of inaccurate or incompetent enrollment information “resulted in $11.7 million in improper payments on behalf of 1,096 recipients who had terminated coverage and another $4.9 million in improper and questionable payments was identified for 319 recipients who died.”

As for reimbursement payments to various Medicaid providers, the audit discovered improper payments to the tune of $15.4 million.

Auditors identified “$29 million in improper Medicaid payments for drugs dispensed after they had been removed from the market for safety or commercial reasons.”

Over $700 million of taxpayers’ dollars misspent. And there might be a lot more that was wasted because auditors only perform sampling tests. For example, they do not review every one of the 244 million claims for payments that were filed with the DOH between March 2019 and September 2019.

In other words, the inappropriate disbursements and overpayments that the auditors discovered may be only the tip of the Medicaid “iceberg.”

In releasing his Medicaid audit findings, DiNapoli declared “The state is facing budget gaps of billions of dollars because of the COVID-19 crisis and needs to find cost savings wherever it can. Hundreds of millions of dollars could be saved with better financial and management controls over the state’s Medicaid program.”

And before Albany Democrats impose tax increases on struggling New Yorkers to pay for the damage caused by Cuomo’s shutdown of the economy, they should heed DiNapoli’s “cri de coeur” and clean out incompetent and corrupt bureaucrats and right-size New York’s bloated government and failing Medicaid system.

The following appeared on Tuesday, September 22, 2020 on The Island Now’s website:

The federal government’s budget deficit is hitting all-time highs and New York’s 2020-2021 state and local government budget deficits are mushrooming.

And if Joe Biden wins in November, his new spending proposals will exceed $5.4 trillion over ten years.

Where will all the money come from to plug budget gaps and to fund new spending? Tax hikes.

Biden has already proposed raising the top income tax bracket on people earning over four hundred thousand annually to 39.6 percent. The capital gains rate will jump from 23.8 percent to 39.6 percent and corporate taxes will go from 21 percent to 28 percent.

However, if the Democrats win control of the White House and both branches of the Congress, don’t expect the radicals to be satisfied with Biden’s plan. My guess is they will insist that rates for income taxes and capital gains hit at least 45%. As for the corporate tax rate, they will probably push it to 35%, the rate during the Obama years.

In New York, Gov. Cuomo has been lobbying for $59 billion from Washington to close the fiscal gaps for the state, the MTA, and local municipalities.

But even if he gets that money from a Biden administration, it’s only a one-shot revenue. It does not fix the structural deficit caused by Cuomo’s shutdown of the New York economy.

Tens of thousands of small businesses and restaurants that will never reopen and the exodus of the state’s top earners will have long-term effects on tax revenue streams.

While Governor Cuomo understands that increasing taxes will not be enough to cover the projected deficits, his message is failing to register with the Democratic-controlled state Legislature.

Those Democrats are calling for the rate on millionaires, which is presently 8.82%, to be increased to 9.6 percent for those making over $5 million annually, and for those earning over $100 million, 11.85 percent.

The most ridiculous proposal is a tax on unrealized capital gains of equity holdings of billionaires.

If enacted, people would have to pay a tax on a stock that has appreciated in value even though the owner has not sold the investment and taken again.

Here’s how that would work: An investor buys a stock on January 1 for $5 a share, that at year-end is valued at $8 a share. The owner would have to pay a tax on the $3 appreciation.

But, say in March of the next year the investment goes south and the investor sells it for $2 a share. The owner not only takes a 60 percent loss on the investment but is stuck paying an unrealized capital gain tax on April 15 on the losing stock that the investor no longer owns.

Sound crazy? It is.

A tax on unrealized gains, by its very nature, is ludicrous.

As for local governments, an important source of income—sales tax collections—continues to decline. In August, it was off 7.8 percent statewide compared to a year ago, and in July it was down 8.2 percent. In Nassau, sales tax revenues, this year, have been down 10.5 percent.

To fill the 2020 deficit hole, Nassau might be able to issue debt through the Nassau Interim Finance Authority. But that, too, is only a one-shot.

Other municipalities may go to Albany and beg for the authority to issue deficit debt.

That remedy, however, only kicks the fiscal can down the road. It sticks future generations—the children and grandchildren of today’s taxpayers—with the bill for this year’s spending.

Unless elected officials at every level of government agree to do more with less, and address the skyrocketing costs of entitlement and pension programs, every form of taxation will have to be increased.

And considering that over 400 thousand have fled New York this year, raising taxes will only exacerbate the situation.

E.J. McMahon, a senior fellow at the Empire Center for Public Policy agrees. “State lawmakers,” he observed, “now clamoring to jack up state and city tax rates on millionaires insist the targeted taxpayers won’t mind—and won’t respond by simply moving. But the new IRS data add to the body of circumstantial evidence pointing to an increased outflow of high earners from New York even before the pandemic.”

With federal, state and local taxes poised to go up, it should come as no surprise if the most robust corporate sector in New York is the moving van industry.