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If we bring not the good courage of minds covetous of truth and truth only prepared to hear all things and decide upon all things according to evidence we should do more wisely to sit down contented in ignorance than to bestir ourselves only to reap disappointment.

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Originally created to serve the poorest and sickest among us the Medicaid program has grown dramatically but still doesn't include the kind of flexibility that states need to provide better health care for the poor and disadvantaged.