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SCOTT JAGOW: Today, a commission in New York issues a report that could recommend the state close dozens of hospitals, many of them in New York City. This could start happening all over the country. Helen Palmer reports from the Health Desk at WGBH.

HELEN PALMER: New York State’s budget deficit is more than $2.5 billion and at least a dozen of the state’s hospitals are financially strapped or underutilized. Many are also old and inefficient.

JIM UNLAND: The heyday of big urban hospitals is going to be soon gone.

Jim Unland edits the Journal of Health Care Finance. He says the rise of outpatient surgery, and dedicated modern surgical centers have cut the need for the traditional hospital.

Cities like Los Angeles have already closed many old facilities in the name of efficiency, he says.

But Howard Berliner, who teaches health policy at New York’s New School questions whether that’s the right approach.

HOWARD BERLINER: I don’t think there’s a lot of evidence that closing hospitals saves money for the health care system.

Berliner says hospitals are also important employers and economic anchors in their communities. And in a national emergency, like pandemic flu or a natural disaster, cities could find themselves drastically short of beds.

I’m Helen Palmer for Marketplace.