I'm the last person here who would defend provider chains, who I believe are in fact at the root of the problems in the American health care system, and certainly the Certificate of Need system --- which applies variably to about half the states in the US --- is stupid, and does restrict the market (most markets are somewhere on a spectrum between free and unfree).

But the alternate problem exists too: hospitals with too many vacant beds, and hospitals shutting down because lack of utilization makes it impossible to pencil out keeping them up and running. That's happening where I am right now.

How is that not just a consequence of market based healtcare? Winners and losers is a natural consequence of market competition, and the instability it brings is natural as well.