The Actual Nanny State
This article is from the archive of The New York Sun before the launch of its new website in 2022. The Sun has neither altered nor updated such articles but will seek to correct any errors, mis-categorizations or other problems introduced during transfer.

Mayor Bloomberg has reportedly refused a demand from Local 1199 of the Service Employees International Union to add 25,000 home-care workers to the city payroll, at an additional cost to the taxpayers that would range from $500 million to $1 billion a year, including pensions, overtime, and fringe benefits. As a result, the union, which is headed by Dennis Rivera, is scheduled to announce today that it will support the Democratic mayoral candidate, Fernando Ferrer.
This is the opposite result from the 2002 Gubernatorial election, when the normally left-wing Democratic union supported Republican George Pataki for re-election after he pledged more than $1.8 billion that would have gone into the state treasury for raises for hospital and nursing home employees who are members of Mr. Rivera’s union.
If a corporation made a similar demand from government, and then used its money and its political muscle to back it up, its action would be denounced as the epitome of special interest manipulation of the political system. They could face serious legal problems if their financial support could be shown to be a quid pro quo for taking action in their interest.
When an aggressive labor union does the same thing, in the most blatant manner, our feelings are more tempered. Yes, it is an outrage for political influence to control economic benefit.
But aren’t the people receiving the benefit mostly poor? Yes, they are, but so is the City of New York, which is facing a $3 billion budget deficit in Fiscal 2007 (just nine months away).
Not only is this a matter of an extraordinary amount of money, between 1% and 2% of the entire municipal budget, but it would be imposed on a city which, financially, is struggling along. If this cost is added to the budget, how will it be made up? Reductions in other services, more tax increases, additional borrowing. The city is barely keeping its head above water now, how will it manage when this additional weight, to be repeated every year, is added to the budget.
There is also the serious question of the differences in efficiency and attitude between public employees and people who work for nonprofits who are in the home health care field. We are all aware of the intricacies of public employee labor agreements, which govern every aspect of their working conditions. You would have to jump through civil service hoops to remove an incompetent or hostile employee, a person who could hold the senior citizen he or she is supposed to care for in virtual bondage.
This is a classic instance of the tendency to expand the delivery of government services by government employees into every nook and cranny of private life. It is one thing to say that the state should pay for home care workers to assist the elderly. That is cheaper and more humane than care in a nursing home. People live longer with home care, are not subject to the infections of an institutional setting, are not alarmed by patients in even worse condition than they are, and are much more comfortable in their own homes than in “nursing homes”.
It is a legitimate function of Medicaid to pay for home health care, although the program is sometimes abused by the wealthy through stealth transfers of their assets, becoming dependents of the state, with no responsibility on their often affluent children. But the difference between paying for the service to actually providing it, with every home care worker becoming a public employee, would have a negative effect on the quality of the care being purchased, as well as making it much more expensive for the taxpayers.
Would you like to ask a government employee to help you go to the bathroom, or to help you to get dressed? Yes, there are many decent people who would do the same good job no matter whom they worked for. But there are others who would not, people who would see their job as an entitlement, and the people they are supposed to help as impediments. All New Yorkers should be aware by now what a laborious and time-consuming process it is to remove an incompetent or perverted teacher from the school system. Do we want to introduce the same legal skirmishing and interminable delay into the intimate process of caring for invalids and senior citizens?
Those who are concerned about the nanny state usually complain about over-regulation by government, objecting to rules intended to promote personal health and safety, like requiring seat belts in cars, helmets for motorcycle drivers and passengers, and restrictions on smoking in public places. Those issues should be decided on their individual merits. They are legitimate subjects for the political process, about which reasonable people can differ.
But no one has yet proposed the state as the actual nanny for so many of its citizens, by making all nannies and home care workers public employees. This would be a new intrusion of the camel’s nose of government reaching into people’s homes, including their bedrooms and bathrooms. Socialism has really not worked out that well in industry or agriculture, as many countries in the world have discovered after enormous expense, loss of life and property, and disruption of social bonds.
But now it is proposed to extend socialism to the living rooms and bathrooms of New York City’s poor and elderly. Recent Supreme Court cases have supported the view that government has no place in people’s bedrooms, meaning that it cannot regulate the sexual behavior of consenting adults. Do we now have to exorcise the state from the rest of people’s apartments?
This is not a matter of raising the salaries of home health care workers. That can be done within the existing structure of nonprofit agencies, reimbursed by the state, paying the employees.
It is, however, a matter of how much of their wages will be deducted for union dues.
The bottom line here is how many thousands of members it will add to Local 1199, Mr. Rivera’s union. Three years ago, the union bested the state, where Governor Pataki was cheerfully coerced (although the election was not even close) into providing $1.8 billion in raises for Mr. Rivera’s members from, among other sources, estimated receipts from Blue Cross and Blue Shield becoming for-profit companies, anticipated cigarette tax revenues, and a raise in Medicaid payments to hospitals. (As if Medicaid were not already the costliest item in the state budget, and in the budget of many cities compelled to pay as much as the state does.)
If Mr. Ferrer is endorsed by the union, one may assume that he has committed himself to meet their demands. How does he expect to find another billion dollars in the city treasury to do this?
What other services would he reduce? What new taxes, in addition to the ludicrous and unproductive stock market transfer tax, is he likely to impose? How much money would he seek to borrow, and who will lend it to him?
How far from reality is his understanding of the city’s finances?
The Bloomberg administration has resisted the demand to socialize the field of home health care and Mr. Rivera and his minions are ready to endorse Mr. Ferrer. If that happens, it will show most clearly the difference between the mayoral contenders. Liberal as Mr. Bloomberg may be as a result of his 1960’s education, progressive associates, and sincere concern for the less privileged, particularly in the area of health and physical and mental well-being, he is nonetheless unwilling to push the city to the edge of bankruptcy by making vast new financial commitments that cannot be kept in the face of an unrelenting structural deficit. For his courage in defense of the budget, he deserves praise. For taking on the powerful union leader, he deserves sympathy and understanding.
Mr. Stern is a former New York City parks commissioner and the director of New York Civic.