Further exacerbating this imbalance in the distribution of income, the increased cost of health care squeezes funding from virtually everything else in state and local budgets, which — unlike the federal budget — must be balanced each year. In Massachusetts, for example, the 63 percent increase in state health-care spending between 2001 and 2014 has been offset by cuts in public higher education (down by 26 percent), early childhood education and child care (down by 28 percent), local aid (down by 44 percent), and support for parks and recreation (down by 43 percent).
