Lee Currie: North Carolina Lawmakers Must Hold Hospitals Accountable
Lee Currie
North Carolina families are tired of being told that healthcare costs are out of control while hospital systems continue operating behind a curtain of secrecy. If Republicans truly believe in transparency, accountability, and protecting taxpayers, then it is time for the General Assembly to take a hard look at waste, fraud, and abuse within our hospital systems.
President Donald Trump has once again put this issue front and center. His administration recently warned more than 500 hospitals across the country for failing to comply with federal price transparency laws, including 11 hospitals right here in North Carolina. These rules are not complicated. Hospitals are supposed to disclose the prices they charge so patients can compare costs and make informed decisions. Yet many hospitals continue to resist full transparency. That should concern every taxpayer and every patient in our state.
For years, North Carolinians have faced rising premiums, growing deductibles, and surprise medical bills. Meanwhile, hospital executives and large healthcare systems have benefited from a system that often makes it difficult for patients to know what they will pay before receiving care. Transparency is not a partisan issue. It is a consumer rights issue.
North Carolina lawmakers should ask a simple question: If hospitals are truly serving patients and communities, why are some fighting so hard against full disclosure of their prices?
The issue becomes even more troubling when we look at nonprofit hospital systems. Organizations that receive substantial tax advantages because they are classified as charitable institutions should be held to the highest standards of accountability. Tax-exempt status is a privilege, not an entitlement.
Take ECU Health, one of the hospitals flagged by President Trump for failure to comply with price transparency laws. As a nonprofit health system that benefits from charitable status, it reported $34 million in profit in 2024. While financial stability is important, lawmakers should examine whether nonprofit hospitals are delivering enough community benefit, charity care, and patient value to justify their tax advantages. When families are struggling to afford healthcare, it is reasonable to ask whether hospital resources are being spent efficiently and whether patients are receiving the transparency and affordability they deserve.
This is not an attack on healthcare workers. Doctors, nurses, and frontline caregivers perform extraordinary and important work every day. The problem lies with a system that too often rewards bureaucracy over efficiency and protects institutions from scrutiny.
State lawmakers should take several commonsense steps. First, we need to strengthen enforcement of hospital price transparency requirements and impose meaningful penalties for noncompliance. Second, we should require nonprofit hospitals to provide clearer reporting on executive compensation, administrative spending, charity care, and community benefit programs. Third, we need to conduct regular audits to identify waste and inefficiency in hospital operations, particularly where taxpayer dollars are involved.
Finally, we should review whether nonprofit hospital systems are meeting the public-service obligations that justify their tax-exempt status.
Republicans have long argued that competition and transparency drive down costs and improve quality. Healthcare should be no exception. Patients deserve to know what they are paying for, taxpayers deserve to know how nonprofit institutions are using the benefits they receive, and lawmakers have a responsibility to ensure that every healthcare dollar is spent wisely.
President Trump has sounded the alarm, now North Carolina's General Assembly must answer the call. The goal is not to punish hospitals, the goal is to protect patients, lower costs, and restore accountability to a healthcare system that has too often operated without enough of it. The people of North Carolina deserve nothing less.
The writer is the former Executive Director of the NC Republican Party
