No surprise really and it is a reason, despite pleas from New York State, I plan to get out when I retire or am out of my current job. Hanging around NY after retirement is for suckers. Besides, I have squirreled away a hefty 401K and I'll be damned if I am turning any of it over to New York State. The only danger is dying before I get out of New York which means they get their hands on it.
As for the health care comment, I would like to know does the Fed look at the state as a whole (which I assume is true)? If you break out downstate, we are close to tops in medical care. Several hospitals in the NYC metro area are at the top of many lists in specialties. There are more doctors, especially specialists in just about any field, around here than in most areas of the country excepting the major U.S. cities. The building that my own physician is located in, in Lake Success, is packed with all kinds of doctors and there are tons of specialties all up and down Marcus Avenue in that area alone (being near NS-LIJ is one reason).