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No, actually it would be lower for the same reason competition always leads to lower prices. Uncompetitive hospitals that can’t meet need would naturally go out of business.

A “need” certificate is similar to the cap that med schools have - it’s effectively a pricing cartel to keep salaries/revenue high

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There are extremely high fixed costs + we require hospitals to do unprofitable work (they aren't allowed to turn anyone away from the ED, for example). In many small regional chains, their profitable hospitals in one area fund unprofitable hospitals in other regions.

Overall we have a crisis of hospitals shutting down, not a crisis of oversupply.

> competition always leads to lower prices

I don't see how this could be true for emergency visits. Would an ambulance drive you to the cheapest hospital within some fixed radius?

Hospitals typically lose money on emergency visits and make it back on scheduled inpatient care and outpatient services. This would accelerate a poor performing hospital's demise, because ambulances will go to the closest one but patients who have options will look elsewhere.

If you now have two ERs within driving range, you have the choice to go to the cheaper one if you are conscious and in a stable enough condition to reflect. This is the sort of thing people already think about in the US.

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