taking on Medicaid

I will be the first to admit that I know nothing about the efficiencies of Medicaid, that I am clueless to the types of services that Medicaid offers or how well they are distributed and my knowledge of how it compares to traditional medical services is limited.
what gets me is that when a friend got injured a few years ago and they went through the entire process of receiving Social Security Disability (SSD) the entire process of a large federal run program's inefficiency hit me across the face like a 2 by 4.   See  when you apply for disability they automatically enroll you into Medicaid which if you need it would be fantastic but if you are not in need makes for a nightmare.   See my friend has their own private insurance through their spouse which has been covering them well for the last decade but what they didn't know was that applying for SSD -and in effect Medicaid- it would mean that the way their entire method of delivering payment for medical procedures would change. 
without realizing it, they were booted from their main private insurance and told that they would only be used as secondary insurance and now without realizing it they were put into a typical example of a bureaucratic roller-coaster.  
now i can't really blame the insurance company as their main business is making money but what gets me is that the entire Social Security system seems to have no rhyme or reason to the way they operate.   First of all, why wouldn't their employees be trained to make sure people who sign up for SSD know that unless they actively opt-out of Medicaid that they will lose their insurance company as their primary insurer.  You basically take somebody who is obviously not in the right place to search the many  documents and read the fine-print.  But even this is typical of how things run.   What gets me is why the hell is Social Security so happy to add people to their already bloated rolls..   
Why -in this day and age of growing debts with cuts imminent in entitlement programs- the Federal government decides that they should be relieving insurance companies of their stated duties is beyond socialistic stupidity.    A company sets up with their stated goal to collect fees for a service and when they have a chance to get out it the Federal Government doesn't regulate it to stop it, but instead facilitates it..

great