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The Goodman Institute Health Blog

What’s Wrong with the Hospital Sector

Posted on April 22, 2026 by John C. Goodman

Policies such as certificate-of-need laws, payment differentials between care settings, restrictions on physician-owned hospitals, Medicaid financing gimmicks, and broad subsidies have driven hospital prices far above inflation, encouraged hospitals to acquire physician practices and merge into large health systems, and weakened consumer pressure on costs. Despite claims of financial strain, the … many hospitals maintain solid margins, investment income, and reserves while spending heavily on administration and other non-patient-care costs. The result is a costly, distorted market that burdens patients, employers, and taxpayers with high and unpredictable prices. To restore competition and improve efficiency, [we need] reforms such as site-neutral payment, stronger price transparency and subsidy oversight, repeal of anticompetitive rules, targeted charity-care standards, and restructuring hospital support programs to reward quality, efficiency, and genuine need.

Source: John Graham, Paragon Institute

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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