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The Medicaid program-title XIX of the Social Security Act-was passed amid great hope on the part of the liberals as the so-called "sleeper" of the Social Security Act of 1965. The optimistic saw Medicare (title XVIII) as a step towards a Swedish form of social insurance and title XIX as a step towards something like the British National Health Service. They could not have been more wrong. While title XVIII has achieved general acceptance, title XIX has lived up to almost none of the expectations of its proponents; it has served only to confirm many of the doubts about government programs of medical care on the part of professional critics and fiscal conservatives.

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