Cass - Here is why West Penn is closing some operations:

Olivia,CEO, said factors forcing the changes include declining government reimbursements on services provided to poor, elderly and uninsured patients; a declining city population base to serve; and a diminished base of private physicians who helped provide referrals. Competition from the much larger UPMC hasn't made life easier. It remains unclear what effect the looming health care overhaul will have.

But health care experts, both local and national, say other major urban hospitals -- particularly those with high Medicare and Medicaid patient volumes -- will be facing similar difficult consolidation decisions in coming years once the full impact of national health care reform hits.

How do you like Obamacare now???