Peter Suderman writes for Reason about the impact for rural health care of the proposed “Medicare for All.”

The core problem, in [Elizabeth] Warren’s view, is politicians who won’t fight for ordinary people. Everything else is just politics. That’s a convenient and politically easy response, but it’s not a particularly good one. Warren’s blithe dismissal of the challenges of uprooting the nation’s health care system and starting over with an entirely new system of government financing allows her to portray herself as a populist champion while ignoring the practical problems that single-payer poses.

Like, for example, how hospitals will be paid in a one-size-fits-all system that pays Medicare rates for every service.

As former Maryland Rep. John Delaney pointed out just a few moments later, Warren’s plan—which is to say Bernie Sanders’ plan—would probably result in a sharp contraction in the number of hospitals.

“If you go to every hospital in this country and you ask them one question,” Delaney said, “which is how would it have been for you last year if every one of your bills were paid at the Medicare rate? Every single hospital administrator said they would close. And the Medicare for All bill requires payments to stay at current Medicare rates. So to some extent, we’re supporting a bill that will have every hospital closing.”

It’s probably an overstatement to say that every single hospital would close. But Delaney is right that under a single-payer plan paying current Medicare rates, some, and perhaps lots, almost certainly would. And many of the hospitals that stayed open would likely shed staff and services.