Increased charity is one of the reasons and of course there is the pressure from Medicare and insurers to limit rate increases, but many insurers are on their way to China as posted in prior articles here.  There is also the big loss of federal funds, just look at us here in California for a quick example to see a real mess.  Nobody can come to terms, we can't even get a proposed budget and a federal judge had to step in to put a temporary halt on the cuts.  

Have we bottomed out with all the "cuts" to where it is not longer applicable, that is if we still want some kind of healthcare in the country?  BD

Downgrades in the credit ratings of U.S. not-for-profit health care systems and hospitals exceeded upgrades by a 2-to-1 ratio this year for the first time since 2003, according to a report released on Monday by Standard & Poor's Ratings Services, the Arkansas Democrat-Gazette reports. The report examined trends at the 138 not-for-profit health care systems and 470 stand-alone hospitals that S&P rates (Arkansas Democrat-Gazette, 8/26).

Much of the operating pressure on the industry that we first observed in the (fiscal year) 2006 medians has continued into 2007, and we expect these pressures to continue in the next fiscal year, especially given the materially weaker economy.

Many Not-For-Profit Hospitals Have Credit Ratings Downgraded This Year, Report Finds

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