IMO, The GOP and DT45 have to pivot to "Single Payer" to keep hospitals open.

[Hoyt]

4. I know what you are saying, but if single payer reimburses hospitals at Medicaid or even Medicare

rates -- which is what would likely happen under single payer -- the hospitals are going to whine and poor-mouth much louder than they do now.

Now, universal coverage might help, but the fact is so much care today is available as an outpatient that small hospitals don't have much chance unless they reinvent themselves. Some areas losing hospitals are opening Night Emergency Rooms, which help provide care for those who can't go during regular hours or where hospitals just can't survive. The ERs are set up to stabilize patients and them get them to proper regional hospital. I know hospitals are big employers in some rural areas, but you can't run a 30 bed hospital with 4 patients unless the area is willing to subsidize the facility. It's a tough situation.