Economists talk about the process of “creative destruction” in capitalism. It’s where a system grows by creating new products and services to replace old ones.

The Huntington Tri-State area has seen its share of creative destruction over the years. Too often, the creation has been elsewhere and the destruction has been here. That’s particularly true of smokestack industries.

People in Fairmont, West Virginia, were surprised last week when they heard their local hospital — Fairmont Regional Medical Center — will close soon. What happened in Fairmont is the continuation of a trend that has hit close to home here in Huntington, the Tri-State and southern West Virginia.

Health care is subject to the same market and political forces as any other industry. Among the big players, consolidation is the name of the game. Case in point: Mountain Health Network, the corporate entity formed in Huntington when Cabell Huntington Hospital acquired St. Mary’s Medical Center.

Smaller hospitals that take advantage of existing regulations and markets can find a niche and survive. Case in point: Boone Memorial Hospital at Madison, West Virginia, which moved into a new 25-bed, $37 million facility in 2016.

Meanwhile, those in the middle will be squeezed and be forced to reduce employment and services. Case in point: Pleasant Valley Hospital in Point Pleasant, West Virginia. Earlier this month, the hospital announced it will eliminate 53 positions when it discontinues obstetric services at the end of the month. The hospital’s plans also call for closing its neurology practice and taking several other steps designed to generate funds to build out and strengthen other services.

In the past year, hospitals have closed in Bluefield, Richwood and Wheeling. Williamson Memorial Hospital filed for bankruptcy in October, and a nonprofit system that operates hospitals in Charleston and South Charleston announced last month it planned to file for Chapter 11 bankruptcy but would remain open.

After the Pleasant Valley announcement, Gov. Jim Justice released a statement in which he said he had met with health care stakeholders to begin the process of creating a rural medicine task force to study the issue.

“The road that led us to what we have seen in recent months — community hospitals across our state shrinking or closing altogether — started a long time ago,” Justice said in the statement. “But now it’s our responsibility to look under every rock for solutions.”

Governors and legislatures can make laws, but they cannot control market forces. Much of what is happening in health care is beyond the control of politicians at the state level, and those at the national level don’t have as much influence as they would like us to believe.

The population in much of Appalachia is aging. Health care itself is getting more expensive as patients’ ability to pay is declining. Cost shifting can do only so much.

Some health systems will grow while others cut back or go out of business. Huntington has a safety cushion with the presence of the medical school and the pharmacy school at Marshall University. As consolidations and closures continue, Huntington, Charleston and Morgantown could see growth while other communities adapt or lose what they have.

Whether Justice and his task force can devise solutions to keep hospitals afloat in smaller communities remains to be seen, but it’s an effort that must be made.