America’s second single-payer system, Medicaid, offers even worse care. Created as part of the same 1965 package that gave Americans Medicare, the entitlement was originally intended to fund basic medical care for low-income patients. Unlike its counterpart, Medicaid is a joint federal-state initiative. States administer the program and receive at least one dollar in federal funding for every dollar they spend on it. Over the years, the program has grown into the largest provider of health coverage in the United States. Today, Medicaid covers one in five Americans—roughly seventy-four million
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