Vanguard Health Systems Inc.'s proposed purchase of the Detroit Medical Center could intensify competition among Detroit hospitals already struggling to stay afloat in a recession. The consumer market for hospitals has been shrinking, and Vanguard, a Nashville-based for-profit health system, could become a formidable rival in southeastern Michigan—especially with many nonprofit hospitals finding it difficult to finance expansions, upgrades, and pricey new medical technology, the Detroit News reports.