Earlier this week I criticized the U.S. Conference of Mayors for going to Washington and groveling for more federal hand-outs. Let me provide some more background for my criticisms with a look at federal budget data. The first chart shows that since 1960, total federal subsidies to state and local government have increased an astounding 1,173%. 

As Congress hashes out an agreement behind closed doors to expand the government’s role in health care, a Medicaid story out of New York serves as another reminder that government is part of the health care problem, not the solution. Audits released by the state’s comptroller found $169 million in misspent funds, including a $196,000 cab bill for a woman who took a daily $300 taxi ride to visit her son in Albany for three years.

A couple of weeks ago I discussed a New York Times report on soaring food stamp use. Yesterday, the New York Times reported that cash welfare use in New York under the federal Temporary Assistance for Needy Families program started to rise more recently. The Times calls this “something of a riddle” given that food stamp usage has been increasing throughout the recession.

Another day brings another example of federal health care fraud. Today’s story comes from “the nation’s healthcare fraud capital” of Miami-Dade County. The government’s crack investigators realized it was fishy that a single county was accounting for more than half of Medicare’s total payments for the treatment of homebound patients with diabetes. Miami-Dade doesn’t even have Florida’s highest rate of diabetes.

That’s the title of a piece in Saturday’s New York Times. That welfare usage is up in a recession isn’t surprising, but if the stigma is truly fading it’s not a positive development. As a Cato essay on food subsidies states, “The [food stamp] program contributes to long-term dependence on government and produces various social pathologies as side effects.” Disturbingly, the USDA official who oversees the program is pleased:  

Official estimates put the amount of improper payments in federal subsidy programs at about $100 billion a year, with Medicare and Medicaid accounting for more than half. The actual loss to taxpayers is probably much higher.

The Obama administration and its allies in Congress want the federal government to expand its role in subsidizing health care. We are told that this expansion will restrain rising health care costs. But an OMB report yesterday that the government made $98 billion in improper payments last year – $55 billion of which came from Medicare and Medicaid – ought to raise suspicions about that claim. 

From the standpoint of Americans who prefer less government, one of the worst developments of the 20th century was the federal subsidization of state and local spending. The result has been bigger government at all levels. Medicaid represents the largest portion of federal money to the states. The states administer their own Medicaid programs, but the federal government picks up 50 to 83 percent of the tab depending on a state’s income. The estimated price tag of the federal share for fiscal year 2009 is $260 billion.