healthcare costs. Obamacare

It’s not an easy time to be a small, rural hospital. Insurance companies aren’t willing to pay generously for your services, given your measly market share. You are increasingly forced to compete against large integrated healthcare systems – conglomerations of urban, suburban and rural providers armed with big marketing budgets and specialized (generously reimbursed!) services….

Many people have warned us that Obamacare will drive up the cost of healthcare insurance, but recent evidence suggests that the problem is bigger than that. According to the Commonwealth Fund, healthcare insurance costs are rising even more quickly outside of the Obamacare exchanges than inside them: