Don't you think HMOs and insurance companies are guilty of the same thing or worse? What about carriers that accept payment from clients until the client becomes a patient and then rescinds the policy based on a mistake in the application? Wouldn't you call that manipulation of a patient's outcome? What of those insurance companies that bonus employees for the degree to which they reject patient's applications for treatment, not manipulation?
I'll take the Feds, profit takes the heart out of the system. Beside, the government is more efficient than industry in administering the systems they oversee.