Quote from CaptKris
What I find common in all programs about public aid, is that when it's time to tighten the belt. It's always someone elses belt. Medicaid and who's paying for what, is a system in which one side is always trying to get the other side to shoulder more load. The patients never benefit. It's not hard to imagine a healthcare system where hospitals start to opt out of medicare and medicaid leaving patients to overcrowd and drown their competition.
Both systems suffer from the problem that each are often considered as insurance, when they are entitlement programs. As with everything else, many equate government programs with instant cash, which leads to vast amounts of waste, fraud and abuse. Am not saying this is the case in the OP, but we as a country simply cannot continue allowing both to grow at rates >3x inflation yearly.
When Medicare first came into being healthcare systems welcomed the plan because at least they would get something for beds that might otherwise lay empty. Medicaid along the same lines, in that again those providing health care for the indigent got some sort of payment.
As for healthcare systems, doctors, and hospitals opting to leave Medicare/Medicaid, it's already happening. In many parts of the country it can take a very long search to find a doctor taking on new Medicaid patients. Medicare *may* be an easier search, but still even there it can be difficuilt in some areas.
Many hospitals are already making noises about leaving the system, especially as Obamacare calls for slashing rates on one hand, but expanding the number of persons enrolled.