When it's got the gummint brand name on it, it's sure to be utility-grade quality at best

The next time somebody extolls the virtues of states that take federal money to expand their Medicaid programs, ask them why so many doctors don't see Medicaid patients.

The problem with Medicaid, Roy says, is that it simply does not pay doctors enough for them to accept Medicaid patients. Medicaid pays on average 52 cents for every dollar that private insurance pays, due to payment caps instituted by the federal government. Some states pay far less: In New York, Medicaid pays 29 cents for every dollar that private insurance pays.

Given the shortage of doctors in the United States, the results of this payment gap are not difficult to game out. “Now imagine you’re a primary-care doctor with a busy practice,” Roy writes. “Two people call asking for an appointment to see you today, and you have one slot open. Do you give that slot to the patient who has private insurance or to the one who has Medicaid?”

If you're letting the government manage your health care, you're done shopping among competitors for value.  You've reached the bottom rung.  You're invisible now, you got no secrets to conceal.