There are a couple of sure-fire ways to lower the crushing property-tax burden in New York. Schools and localities can drastically cut spending, an unlikely and, in some cases, unhealthy scenario.

Or the state could pick up the full tab for big-ticketed items, such as education and Medicaid spending, shifting the part of those bills now picked up by property taxes on the local level.

The state isn’t in a position to do this fully but, over time, it’s imperative to work in this direction.

A recent report by the Empire Center, an Albany-based, fiscally conservative think tank, projects if the state paid for the counties’ share of Medicaid costs, it would provide $8 billion in relief to county governments. That’s an average 27 percent reduction in county taxes, the USA Today Network’s Albany bureau reports.

While this report is new, the issue is not. For decades, counties have tried to get the state to takeover these costs and, in fairness to the state, progress has been made — but not enough of it. Counties once paid about 25 percent of Medicaid costs while the state paid 25 percent and the federal government paid the other half. That percentage has essentially been cut in half for the counties. But New York is still one of but a few states that forces its counties to share any of the costs the program, which accounts for about 37 percent of the property taxes in the Dutchess County budget.

The Medicaid program does tremendously important things. It, in part, provides health care to the poor and elderly and enables those with disabilities to get help in institutional settings or group homes. But no one of sound mind would assert the state’s system is run efficiently. Various reports have cited the program’s bloated bureaucracy and outright abuses to the system, including nursing homes and health officials collecting money, even though they were no longer caring for those patients who were supposed to be benefiting. What’s more, people often hide or reduce their assets to qualify for Medicaid-paid care intended for the needy, a difficult problem for the state to address.

Over the years, advocates for change have suggested everything from placing a spending cap on the program to putting a limit on medical malpractice damages. Surely, the state should put a deep emphasis on preventive care that ultimately helps keep health costs down.

There is simply no denying the facts that the state spends about twice as much per person on this service as any other state and continues to bill the counties for parts of those program.

The state should address its responsibility to hold down costs and, as much as possible, lift this financial burden from the counties.