Hospital closures have been called a “new public health concern,” but it’s a phenomenon that isn’t new at all. Particularly in rural areas, hospital closures have been happening for decades because healthcare’s business model is fundamentally broken. As we were recently reminded, if there aren’t swaths of people signing up for elective procedures or in need of emergency care, hospitals can’t keep the lights on.

Whenever a hospital is on the brink of closure, the initial reaction is a scramble to save it with a financial bailout because of the negative impact its closure would have on patients. That’s why the government has spent $178 billion in provider relief funding thus far, and even though some hospitals stayed profitable throughout the pandemic, why HHS is currently considering extending the June 30 deadline by which providers need to spend their bailout bucks, or return them.

This article was originally published on Forbes.com.