It is well established that health care businesses are confronted with significant financial challenges, including lower reimbursement rates, constant changes in the delivery of services, increased competition and the need for expensive capital improvements to adopt the latest technology. Recent political uncertainty and heightened government scrutiny has only exacerbated these challenges.

Rural hospitals in America are closing at a rapid pace, and many others are experiencing severe challenges. The statistics reflecting the closings and financial challenges facing rural hospitals are readily available, but that is not the focus of this article.

The economic challenges in today’s current health care climate are well documented and run to the core of a fundamental national debate rearing its head in the upcoming 2020 election cycle. “Medicare for All” is more than a sound bite or political posture; the larger issue is whether U.S. citizens believe that access to affordable health care for all is a right in this country.

Many Americans lack health insurance.[1] Even people with health insurance may seek care from out-of-network hospitals that don’t participate in their health plans.[2] That is what happened with the debtor in In re Dietrich, because “his heal