Obamacare Taxes for All does not limit the scale problem

Medicare For All Would Improve Hospital Financing Health Affairs

The author of this post based the evidence entirely on supposition of a switch from patient funding to global hospital funding. Little evidence is cited.

Rural hospitals are closing now, under Obamacare, they will close at an accelerated pace under Medicare for All. Rural areas, whether in Texas or all of Vermont, do not have economies of scale for hospitals, they simply do not have the patient flow concentrated in a single presence.

The global funding method pays according to efficiency, in the medium and long term. They will thus force rural states to depopulate to the extent rural states have high medical costs.

And it is not just medical, it is also college funding, favors the larger economies of scale and draws young kids away from rural areas.  I always mention the senate and small states because they have a senate vote while rural Texas is effectively unrepresented in the senate. 

It becomes obvious to small state capitals what is happening, budgeting at the federal level does not favor small state budgets at all. Obvious comes when they are facing a tipping point and begin to look in earnest at the problem. Small state senators have no choice, there i no thing as voting for the extinction of the small states.