Dear Editor, In his recent commentary for VTDigger, James Hodge was correct in his observation about proposed hospital transformation plans: Simply applying the same prices to a small hospital as a large hospital will not work in our current system. Things would be quite different, however, i f we had a universal publicly financed single payer, or at least a single payer for hospitals. We would then have global budgets for hospitals, which would actually give them more freedom to do what Hodge says they need to do: figure out what to prioritize in order to best serve their communities.  With a global budget, they wouldn’t have to eliminate a necessary service like maternity in favor of a service that pays more but might not serve the local community’s needs as much, such as orthopedics. That is exactly what happened at Copley. READ MORE If we fund our hospitals as a public good, then smaller hospitals will have more leeway to plan based on need rather than simply fit into a cookie-cutter model imposed from above. Ellen OxfeldMiddlebury, Vt. Read the story on VTDigger here: Global budgets would free hospitals to serve patients, not profits. ...read more read less