1. A well-run hospital is a well-run hospital, whether it is in a small town in Kentucky or in Bethesda, Maryland, where our royal public servants go.
2. A poorly-run hospital is a poorly-run hospital, whether it is is a small town in Kentucky or in East L.A.
3. A hospital which is staffed with people who care, will care for their patients well, even if those patients are indigent.
4. A hospital which allows staff who don't care, will provide poor care for their patients, even if those patients are wealthy.
5. Only competition will weed out poor service, even in hospitals. Every time you build a superior hospital and stock it with superior administrators and staff, you will run a poorly-run hospital out of business. Unless the poor one is run by the government.
6. Government hospitals get clients whether they give good service or not.
7. Fancy equipment is fine, but it doesn't replace caring doctors and nurses. Some of the most poorly equipped medical facilities are in Mexico (and other countries without a lot of money) -- and some of the finest caring doctors and nurses work in those facilities. Sometimes a doctor or a nurse who will sit by your bed all night with a cool damp cloth and concern in their eyes makes up for the lack of medicines. And don't think those people don't exist. Even in the most desperately poor countries of the world. Even in the USA.