> Urban hospitals and large rural hospitals are able to make up for the losses from Medicare and Medicaid patients with what they can charge private insurers. S

> Urban hospitals and large rural hospitals are able to make up for the losses from Medicare and Medicaid patients with what they can charge private insurers. Small rural hospitals can’t do that. The articles argument is that private insurers need to cover medicare/medicaid costs, which seems silly. It also seems to ignore the obvious question in my mind, which is maybe rural hospitals just have to run leaner to meet market demands. It makes me wonder if there's a reason rural hospitals pull large investments, such as regulation demanding unattainably high levels of care, forcing them to be unprofitable.