There cannot be efficacy in programs like Medicaid and financial aid - they were built on liberal ideas. They HAVE to be reformed. Of course businesses will seek to profit from systems like this if we basically stamp the fundamental method of the program as "We'll pay for anything! Just send in the paperwork!"
We should fight for the efficacy of Medicare and Social Security, not weaken the basis of their premise; in my view, as an intellectual, as try-hard, as an earner, we must care for people that cannot (or refuse to) care for themselves and pay for it with our hard won dollars; we must not cheapen care to save ourselves a buck we probably don't need.