Dr Waits struggles valiantly in the discussion to avoid using the terms profit and subsidy. This is a mistake in my opinion, while you can talk about healthcare efficiencies, people need to hear that large hospital groups are for profit, yes even the not-for-profit ones. People need to understand that rural hospitals are not affordable without subsidy. Equally, urban communities need to understand that without rural communities, we have an entirely different set of problems.
Subsidy isn’t a bad word, nor is tax that ultimately is used to pay for it. You can either levy tax at a state level or at the federal level, preferably on big hospital groups and medical providers revenue(not profit). You can then use that tax money to subsidise rural healthcare. Or you can use general federal taxation, and use the additional money to fund a medicaid hospitals in rural community cities.
Struggling along with no real honesty, and without confronting the elephant in the room, will just mean more rural hospitals closing, leading the to further decline of rural communities and the increased pressure on cities.
Read my earlier post “Can America Afford It’s Rural Communities?“