Comment: County Health under Rob Rockstroh, with assists from those that wanted medical managed care - contracted with a private 'for profit' business.  All the while LIPA complained reimbursement rates were inadequate.  Somehow, with this cost basis, LIPA managed to make itself not only attractive, it made Medicaid sale-able / cashed out, and sold us out with it.  Levels of care WON'T improve, I'd like to have the public discussion with those that think so.  The other thing is the "successes" cited are from money from the Fed's, NOT Centene or Agate. Centene risked / built nothing to make their Federally Qualified Health Centers.   We rely on professionals, and sadly trust them to 'save us.'  Example: Remember the old "frivolous malpractice suits are driving high costs" argument for malpractice reform? In states that limited malpractice liability, when insurance rates went down, doctors flocked to work there.  Mysteriously, savings were not passed on.  Bad prospect if you need MD's to survive.