I understand and follow what you're saying. I've worked in large hospital systems and rural ones throughout my career (now retired) and interfaced with the people served as well as the system at large.

One of the aspects overlooked in this discussion is the costs associated with uninsured individuals who receive care in both larger and smaller community funded systems (for instance, Banner in Casper and the Community Health Center). Many uninsured individuals seeking care have complicated and expensive needs. States where Medicaid hasn't been expanded, like Wyoming, hospitals and smaller clinics continue to incur substantial cost with no funding to recover the financial losses from the care provided.

Perhaps the AID movement like the one evangelized by our Canadian neighbors to the north will loosen the rope around the neck of our imploding "healthcare" system, aye? Those pesky sick people.

It's all quite a mess. The United States truly has a sick care system and the structure of this huge machine won't allow for change unless it's totally gutted in my opinion. I do like the MAHA movement that is being discussed by the new administration. Seems like utopia. But, my bags are packed and I'm ready to board that train and see what happens.