I remember a time when there were more hospitals and they serviced the local community.
We always thought the one in my town (gone now) to be a butcher shop but they did a good job stitching kids up, setting fractures and handling most of the stuff that happens in life.
What changed?
My uneducated guess.
A. The absolute mandate that everyone gets care even if they cant or have no intention of paying
B. Hospital mergers under big care providers squeezing out competition and resulting in closing facilities that hurt the financial reporting
C. The idea that insurance is nameless, faceless and provides free money. "Fuck it charge aspirin at $35 a pill, he has insurance and we can use the other $34.50 to help defray the cost of the guy we had to give free care to".
D. Lawyers. Covering your ass costs money. If there is real negligence - fine sue - but if you don't realize that going into a building full of sick people may lead to an infection and complications well sorry unless you can show me someone was sterilizing instruments in the shitter maybe you don't get the $150 million pay out. Drs and hospitals probably pay a shit ton for liability coverage.
E. What happened to the General Practioner? The guy that lived in the old Victorian with his residence on the top floor and his practice on the first floor. The guy with tongue depressors and made you say "Ahh!". The guy that would give your yearly physical, could stitch a cut, set a sprain or simple fracture and showed up at your house to take your temperature. He knew his patients and if he knew the Jones's couldn't pay cash Mr Jones was a plumber and he could fix the leaking kitchen faucet in the Victorian. My GP when I was a kid was a Korea veteran that worked a MASH he was likely a lot more capable but liked working with his families. Im guessing A, B, C, and D above killed his existence and helped flood the hospital emergency rooms.
If any of this is right, how do you fix it?