Over the last several years, each time a periodic report on U.S. hospital closures is published, the count of those failing financial stress tests and at high risk of closure increases. The figure now nears 800 across the country. In the meantime, many anticipate that the recently passed One Big Beautiful Bill will swiftly exacerbate these closures and further diminish health care access for American citizens.

Prominent reasons for the accelerating hospital closures, particularly affecting rural and other disadvantaged areas, are numerous, including: Insufficient reimbursements to cover rising expenses, lower reimbursement rates specifically allocated to rural and other disadvantaged hospitals, and a declining ability to recruit and retain doctors, nurses, and other health care professionals.

However, these very hospitals are the essential foundation of critical access and safety net health care facilities, which serve as the only available option for an increasing number of Americans, especially in rural and other disadvantaged regions like inner cities.

All of this occurs during a time when U.S. health care has become the most expensive globally, yet delivers the poorest outcomes, with more than 35 percent of American citizens unable to afford or access continuous health care. Consumer confidence and trust in the health care system are at an all-time low, resulting in, among other issues, a rise in health care workplace violence. Hands-on health care is now categorized as the most hazardous profession in the U.S., due to violence and assaults, prompting ongoing exits from direct health care roles for safer, less abusive careers, alongside numerous other significant disruptors.

Yet, this is also a period when our political and health care business leaders and stakeholders, fully aware of these escalating issues affecting health care delivery, opt to look away and concentrate on what they deem more urgent and significant time-sensitive economic, national-global geopolitical, warfare, and other crises and demands.

This inclination to disregard may stem largely from a pervasive belief among leaders that altruism and a “calling” in health care will sustain those who continue to provide hands-on patient care in challenging conditions, expecting that the system itself (altruistic and supposedly too big to fail?) will eventually adapt to make it all work. Consequently, paradoxically, these beliefs lead leaders to think they have the luxury to focus on different matters and return to health care delivery when it’s more opportune and appropriate. In reality, no one seems to envision this country without a seemingly operational health care delivery system, leading to the mindset of “I’ll consider it tomorrow.”

History teaches us: Hubris among leaders can lead to downfall.

This tendency to look away and postpone matters resonates with similar decision-making patterns that contributed to the Titanic disaster, where up to 17 or more identified issues collectively led to the sinking and tragic loss of life.

The crucial aspect of this descent into disaster is that the Titanic’s leadership, fully conscious of these problems, chose to ignore them. Their belief that the Titanic was unsinkable and too significant to fail made them prioritize other concerns, such as speed records and rising profits, as more urgent and worthy of immediate focus.

Will health care delivery endure a comparable fate? No system is too large to fail.

The views expressed are solely my own and do not necessarily reflect the views or positions of my employers or associates.

Harry Severance is an emergency physician.