Hospitals are very interested in running their operations close-to-a-loss. This is more important than the spend-share on equipment or salaries. Hospitals are

Hospitals are very interested in running their operations close-to-a-loss. This is more important than the spend-share on equipment or salaries. Hospitals are setup mostly as non-profits, which means they have no incentive to have an operating margin. Furthermore, hospitals can have lots of leverage, as sometimes they are the only one in 20 miles or more: so the closer they are to bankrupcy, the more money they can ask government. Hospitals are very close to the mercantilist corporations pre-liberalism in this way: they are protected from competition and from their own failure.