Yeah, don't you think a. there would be less PE demand for these hospitals if they didn't come with a free state-enforced local monopoly, and b. it would be easier for competitors that don't suck to open up, and c. PE guys could get away with less quality degradation if there wasn't the aforementioned local monopoly?

But PE owned hospitals also suck when there is no locally enforced monopoly. They even suck when it is easy to open competing hospitals.