Although every idea to reduce health care spending needs to be examined and discussed, this one will not accomplish the goals of its advocates. Capital spending decisions are developed in a long and thorough process beginning with hospital trustees. These questions inevitably revolve around quality of care issues. There are no easy and clear cut answers to these questions. This is the reality we face.
Patients do vote with their feet for some services.
If they cannot get the standard of care they want in their own community, they will travel to where it is available. Obviously, for emergency care this is not the case, but for services where patients have choices, they exercise them. Patients who live in Bellows Falls, Vermont, for instance, can receive care in Brattleboro, Springfield, Claremont, New Hampshire or Keene, New Hampshire. All are in easy driving distance. They can and do make choices.