Some say the health care system could stand to shrink a bit. Here, Alan Sager of BU uses the sudden closure of North Adams Regional Hospital to argue that the wrong hospitals are closing. Hidden on the Globe letters page:
Over half of the Massachusetts hospitals open when John F. Kennedy was elected president have now closed. Not one that closed was a major teaching hospital. Heavy reliance on teaching hospitals helps explain our state’s extraordinarily high hospital costs. The pattern of closings may be partly responsible for that reliance.
Some might suppose that a functioning free market protects needed and well-run hospitals while closing unneeded and inefficient ones. Sadly, that pattern seldom prevails. Low-cost, efficient hospitals are not likelier to survive. But hospitals in wealthier places, with more patients insured by higher-paying insurers, rarely close. Some call this survival of the fattest.
More good work from the Globe health desk here: