This is the Wilmington Standard Daily Update for Tuesday February 10, 2026.

North Carolina is finally realizing that allowing hospitals to consolidate and buy smaller medical practices only results in cost increases across the board – especially in rural areas – and not in better access to medical treatment.

Thomas Friedman - executive director of the North Carolina state health care plan – told the Center Square that many providers are concerned about “the consequences of consolidation and the loss of independent practices” across the state.

In other words, large providers like Novant are buying up small medical practices and clinics – turning around and billing for hospital services in facilities that are no where near a hospital – and raising the prices on everyone.  All these hospitals have to do is add a simple code change to the billing – and voila they can now charge hospital rates for the exact same services provided for before the hospital took them over.

The answer to power and money grabs like this is to let loose the economic powerhouse of the free market.  If counties and communities want better care, or local care, or specialized care catered to their community – it seems they should be able to do so.  If doctors want to band together and start offering services that go beyond the regular doctor’s visit – and charge a price that will keep that service going – what should stop them?

According to North Carolina Law – North Carolina can through the Certificate of Need requirement.  In our state the government determines where hospitals can go and what kind  of health care institutions can be erected.  It does not matter what the locals want, the state directs when and if facilities are erected.  And since the Certificate of Need favors established medical institutions like Novant, it is all but certain that any new facility will be blocked by the medical powerhouses.

North Carolina needs to scrap – or severely overhaul – the certificate of need program that is leading to large medical entities establishing monopolies and empowering them to muscle their way into small and independent clinics.  If even the state is complaining about the rising price of health care as a result of these consolidations, just imagine what it is doing to small and independent businesses and those they insure.

The Certificate of Need is aptly named – for it is indeed a CON – and all of us are paying for it.

For the Wilmington Standard, I’m Reuel Sample.  Thanks for listening.