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Having first hand experience working in a consulting capacity (staff) at a regional hospital, some of the palatial-ness and extravagant architectural finishes (artwork, tile, glass, soaring spaces) come from donors.
I am of the view that the healthcare system in the US is utterly broken. But on the topic of what can be seen in regional hospitals, some of the money in the brick and mortar comes from private, discretionary donations.
To me, cost improvements are needed in operational efficiency, prices paid for materials (drugs, machinery, consumable supplies) and prices paid to care providers in the form of salaries, fees and reimbursement rates.
Reform of the legal climate (e.g. malpractice) in this space is also needed. I am not qualified to make suggestions in this area.
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