The present study was undertaken for three reasons: Medicaid is a vital program - in the early 1970s it provided care for over one tenth of the American population. It is a huge program - in the same period it consumed over nine billion dollars of public funds. And Medicaid is, in many ways, the most direct involvement with the provision of medical care undertaken by either the federal government or the states. But up until the publication of this book, Medicaid had not been studied in depth or in a systematic way.