> This fact is missing something essential; Kaiser Permanente is a nonprofit but it sure isn't what you think of when you use that term.

Why is that? You don't think they lay people off in Canada or Japan when there's no patients? Even single-payer systems can have private hospitals. They are simply paid by the govt instead of (or really in addition to) by patients. They still need business and to balance the books.

Canada has a similar mix of all kinds of hospitals like the US, though it may be more slanted in some way.