“Follow the money” helps us figure this out. Inpatient hospital beds generate two bills: facility fees and professional fees. In most public hospitals, both go to support the whole operation. But not at UW Medicine, which operates a separate company, UW Physicians (aka Association of University Physicians), that uses the professional fees to pay bonuses to physician leadership, doubling and tripling (the former dean) their State-paid compensation to over $1 million annually for several. So a Harborview neurosurgeon earning $657,000 in his State paycheck collected another $430,000 from the private company, as well as $127,000 in “other compensation.” Altogether, 831 UW Medicine leaders earn at least $100,000 each extra from this company that collects, then redistributes professional fees paid for subspecialty surgery and intensive care on mostly private insurance patients.
This is the wikipedia page about why we no longer involuntary commit people: https://en.wikipedia.org/wiki/Deinstitutionalisation
And for a fictional portrayal, the go-to is "One Flew Over the Cukoos Nest": https://en.wikipedia.org/wiki/One_Flew_Over_the_Cuckoo%27s_Nest_(film)