[dragonwriter]

> Medicaid is much higher (~6% I think) because it is so targeted and is really administered by 50 different agencies on top of the feds.

And because, while Medicare is usually a primary payer, Medicaid is the payer of last resort, so Medicaid has a lot more expense in verifying that there isn't another payer with an obligation to pay (including Medicare -- there is a substantial population eligible for both programs) that should pay before Medicaid, or reimburse Medicaid.