Another way of reading this plea by the hospital industry is that they have an unsustainable business model that has been made viable and even prosperous for many years by the government voting them money. Whatever else the PPACA, DSH payments, and facility fees were, they were ways for the feds to favor hospitals over their competitors (private physician offices, outpatient surgery centers), with the justification that all these hospitals are necessary to provide medical care in their communities. I reply, no, they’re not all necessary, and showering money on hospitals only delays the transition of health care toward innovative means of providing outpatient and in-home care.
I don’t think that all hospitals should close, of course, but we have more than we need in this country, and we will not be able to find out how few we need to meet our healthcare goals until the government quits propping them up.
Direct primary care is a threat to hospitals, because its goal is to give patients good, thoughtful, attentive care that prevents the need for many ER visits and hospitalizations. DPC is bad for hospitals, but it’s good for patients, and if the government wants better health for its citizens it should find ways to be supportive of direct primary care instead of pouring more money into the hospital industry.