The problem is a mix of people leaving rural areas which increases per patient overhead at facilities, plus mergers and private equity takeovers.
Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too.
Though the consolidation is something of a mixed bag. My community hospital network had some pretty good docs but lab work, appointments, and so forth was pretty much faxes and phone calls which sometimes worked. Now they're on Mass General Brigham's electronic records system and it's a lot better.
It's not quite that bad. For example, the Boston area is arguably as good or better than those two cities. And some higher-income relatively small town/rural areas are pretty decent. But it definitely becomes a bigger consideration as you get older--although you can of course get unlucky at any time.
It’s a problem in the medium sized cities too? Because many of the smaller rural facilities are being closed down (often in the wake of for-profit buyouts), and then all those displaced patients overrun the remaining facilities in surrounding towns.
Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too.
https://www.kff.org/health-costs/issue-brief/ten-things-to-k...