First as a top aide in New York City’s budget bureau, then as its chief for the second half of the 1980s, Mr. Dickstein rode herd over city finances at a time when the fiscal crisis of the 1970s still haunted policy makers. He graduated from James Monroe High School in the Bronx and Columbia University and earned a law degree from New York University. He entered city government as a lawyer in the budget office in 1970 under Mayor John V. Lindsay and later served as the first deputy commissioner in the housing department and a commissioner in the Police Department. He was the budget chief from 1985 to 1989, when Mr. Koch left office. In 1993, Mr. Dickstein founded Health First, a large managed care provider owned by 18 hospitals in New York City. He resigned in 2007 after the state temporarily shut it down because of allegations that the company had violated state laws governing health maintenance organizations. In 2008, Health First agreed to pay the state $35 million in a settlement. Mr. Dickstein went on to work as a health consultant. Mr. Dickstein married Risa Glaubman, but their relationship ended in divorce. In addition to his sister, his survivors include his wife, the former Robin Gitman; two children from his first marriage, Isabel and Anthony Dickstein; a daughter from his second marriage, Veronica Dickstein; and another sister, Diane Dickstein.