Researchers studied the impact of public hospital closures or conversions in Milwaukee, Boston, Tampa, Philadelphia, and San Diego. The good news is that some localities seem to have invented a better way to deliver and finance care for the poor at an affordable price. The bad news is that it is at best a struggle to maintain funding for indigent care in the absence of a public hospital. The authors conclude that a robust local safety net needs non-local funding, and safety net policies need to be made at local and higher levels of government.