Story after story follows the same format. Medicaid doesn’t pay doctors enough, so patients can’t find care. Large federal subsidy program is implemented. The large federal subsidy program sort of helps but is also inefficient, easily shunted to special interests, defrauded, and otherwise succumbs to the same things that many large federal subsidies do. The individual state, which is actually responsible for setting medicaid rates, and is thus responsible for the problem in the first place, sees the large subsidy program and loses all incentive to fix the funding problem. Then some politician comes along and sees the massive amount of waste in the federal program and tries to cut it back. Now everyone wails that they can’t possibly treat medicaid patients without the large federal subsidy program. New politician comes in and not only restores the program, expands it to include interest groups that just helped get him elected. Rinse and repeat.