Medicaid is enormously expensive. For the second year in a row, spending on Medicaid (for the poor) will exceed spending on Medicare (for the elderly). At $280 billion this year, Medicaid costs almost $1,000 for every man, woman and child in the country - or $4,000 for a family of four. Indeed, it is likely that many taxpayers are paying more in taxes to fund health insurance for the poor than they pay for private health insurance for themselves and their own families.