Legend has it that it was a bottomless basket. As much tribute to the master as could be piled into it, the basket took more and more and more.
Obamacare provides health insurance coverage, but coverage is not access to care. For care, you need physicians and you need to be able to see a physician, the right one, when you require care.
ACO’s. Competition by hospital employed physicians. Commoditization.
If a hospital’s demands on your group have markedly changed but the compensation for your services has not kept pace with the market, it’s not only unfair, it’s immoral, that you continue to eat the burden.