ABSTRACT
Medicaid's experience has shown a series of government units becoming more organized because of the cost implications of Medicaid. Medicaid was destined by its very extensions and rationalizations to establish a widespread system of government-guaranteed health benefits. But although Medicaid has been beleaguered by structural and functional defects, its incremental approach to social legislation has major positive effects. Medicaid was the culmination of a continuing thread of argument in Congress, going back at least to the 1940s, calling for an approach to medical care provision through welfare instead of through a general program of health insurance. Medicaid's early "mainstream" connotations were bound to be inflationary. Medicaid provided a remarkable opportunity for the states to provide services to their citizens at federal expense, while at the same time raising vendor reimbursement levels. One of the problems Medicaid faced, and all government health care programs will face, is the relationship between the government and existing medical structures.
