New York City hospitals are often dependent on public support, and many of them have hired friends and relatives of elected officials, or sometimes the officials themselves. Despite thin experience, the wife of Councilman Erik Martin Dilan, in one recent example, worked as a $75,000-a-year director of public relations at Wyckoff Heights Medical Center in Bushwick, in Mr. Dilan’s district. Assemblyman William F. Boyland Jr. of Brooklyn was indicted in 2011 on federal bribery charges when prosecutors said he received a no-show consulting job for Brookdale University Hospital and Medical Center in exchange for helping the hospital in dealings with Albany. Jurors acquitted Mr. Boyland, saying in interviews that they did not think the job rose to the level of bribery; he is now facing bribery charges in a separate case.

Ms. Brier said she made her annual requests for money to Brooklyn’s City Council delegation as a whole, not to Mr. de Blasio specifically. But it was Mr. de Blasio and a fellow Brooklyn councilman, Michael Nelson, who recommended the city give $5.7 million to Maimonides, according to City Council records. The money was given over several years, from 2003 to 2009; according to Eileen Tynion, a hospital spokeswoman, most of it was for a cancer center.

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Ms. McCray’s salary was $90,000 when she began working at the hospital in 2005 and was $114,000 when she left in 2010, according to her husband’s campaign. At first she worked part time in human resources and part time in the executive office, until a job opened up in marketing, Ms. Tynion said. Ms. McCray’s biography on her husband’s Web site says that she was “immersed in the challenge of developing culturally sensitive messages in a hospital environment.”

Jerry Della Femina, chairman and chief executive of Della Femina Advertising, recalled working with Ms. McCray on an ad campaign that depicted “a bunch of tiny babies” with the message, “At Maimonides, we’ve learned to say goo goo in 68 different languages.”

When David Paterson’s became governor in 2008, his wife was employed in the health care sector by Group Health Inc. (GHI), part of the Emblem Health group, which is descended from New York City’s municipal health insurance plan. This link promoted some raised eyebrows in the 2010 when the Paterson administration awarded GHI a $297 million Obamacare-related contract on a no-bid, no-public notice basis.

At least Ms. Paterson, who has since separated from the former governor, had a degree in health care management. In the case of de Blasio’s wife. the head of Maimonides was impressed  ”because [Ms. McCray] had speech writing experience under former Mayor David N. Dinkins, and because the hospital needed more minorities in administrative-level positions,” the Timesreported.

A leading hospital executive’s admitted willingness to “invent” a job for a political spouse with no healthcare background should be recalled the next time a healthcare funding battle erupts in Albany (which is bound to happen sooner or later) and the Greater New York Hospital Association responds with ads claiming healthcare cuts will “jeopardize patient care and destroy our communities.”