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Although Specialty Hospitals (SHs) represent a very small fraction of the U.S health care market, the competition for patients has generated bitter controversy. Owners and investors argue that patients (consumers) deserve a choice of SHs, which contributes revenues for the local community and delivers more efficient, specialized care compared to general hospitals. General hospitals (mostly not-for-profit) contend that SHs tend to provide nonemergency care for the insured population with “profitable” illnesses. It is one of the issues that is proving divisive in the effort to align incentives for physicians and hospitals. A high profile, public debate involving the State legislatures and Congress is currently being waged that will determine how, where, at what price, and how much access to healthcare the public will receive in the future.