This article from The New Republic is 9 years old, but presents a case study of one hospital's experience pre and post "Harry and Louise". Remember them? It's worth considering in view of all that has been said about health care reform this past year.
While there was wastefulness in Boston's health care market a decade ago--the city was probably due for a hospital shakeout--one would have hoped market pressure would have penalized substandard hospitals and rewarded good ones. Instead, Beth Israel is in trouble largely because it provided good care, which is necessarily expensive. Because it took on burdens like caring for the indigent and training young doctors, which American society largely refuses to shoulder. And, perhaps, because it made some ill-advised business decisions.
That was 9 years ago.