Tough decisions, most often, are not popular ones.
It is why few area politicians and elected officials make them. It is easier for them to point fingers at New York state or raise taxes and fees than do something tough and unpopular.
Non-profits and private businesses, however, cannot just raise fees on products or services to cover their shortfalls. Which is why, as difficult as it is to state, Lake Erie Regional Health System of New York made the right call in not replacing the former Tri-County Hospital in Gowanda.
Already, Chautauqua County has four hospitals. Gowanda, which is in part of Erie and Cattaraugus counties, also is potentially served by numerous hospitals in the Buffalo area.
What happened in 2009 to Tri-County Hospital was tragic. But since the hospital was destroyed in the flood and later demolished, the reality is the need for that facility has lessened.
Already, too many Western New York hospitals - not just in this area - are bleeding in red ink when it comes to their budgets. Lake Erie Regional Health System of New York has laid off personnel at its hospitals in Dunkirk and Irving to compensate for declining revenues.
How was it supposed to afford to build another hospital and staff it? In the end, the current administration decided it could not.
"I don't think it was ever practical to expect you would have a full-service hospital built there," said Gary Rhodes, interim chief executive officer at Lake Erie Regional Health System. "When you look at what we're going through right now, it's very difficult, problematic. It's difficult to have two hospitals within 12 miles of each other, let alone to think there's three."
You can cite a number of reasons for the decline in revenues for the non-profit, but when population figures in the region continue to plummet, the number of potential customers does as well.
If Tri-County Hospital were a school district, the building would have been rebuilt with state aid and taxpayer subsidies - just to continue to exist.
But Tri-County was not a school. And even though a hospital with 25 beds was projected to cost $23 million in 2012, Rhodes disputed the figure.
"A new hospital in the area of 25 to 30 beds, you're talking at least $50 million," he said.
We do agree with Perrysburg town Supervisor Dennis Stopen, it is an "unfortunate event." But you can trace the decision to the changing health-care landscape and something our overabundance of government and school districts promote: a downsized population.