Medicaid became party of modern Democartic ideology as part of LBJ's "Great Society", as did Medicare. The reason the hospital rates are so high is because so many people abuse the hospital ER as a clinic, instead of going to privately funded clinics or signing up for Medicaid. There is a piece of federal legislation, known as EMTALA, requiring hospitals to treat any person who signs into the ER, regardless of their ability to pay the bill, regardless of income or immigration status. This legislation, btw, was signed by President Reagan. These people also know that they are not required to pay the bill, even though they signed a legally binding contract. Debt collection laws favor the consumer. All the consumer is required to send a written notification to "cease and desist" any contact including further collection notices. They just have to keep doing it for seven years till it falls off credit report and, Voila!, free healthcare has been given. It is a Mexican's wildest dream, as they abuse ERs in the Southwestern states of CA, AZ, NM, and TX.
The way I see it, there are several things that need to be done to reform healthcare.
1. Repeal Obamacare or defund the program.
2. Repeal EMTALA and replace with legislation requiring patients to provide proof of citizenship or resident alien status. The hint here is to deny healthcare to illegal aliens, undocumented workers, "new Americans", or whatever the hell you want to call them.