North Carolina’s healthcare system is failing its people — not because it’s too free, but because it’s far from it. While free markets thrive on competition, innovation, and consumer choice, our healthcare system often lacks these benefits, with North Carolinians footing the bill through skyrocketing costs and worsening health outcomes. This is not the freedom our state stands for, nor the future we should accept.
The most expensive healthcare in the nation
North Carolina now holds the dubious distinction of having the most expensive healthcare in the country, as highlighted by a recent Carolina Journal article. Residents face inflated costs driven by misaligned incentives that prioritize treating illness over preventing it. Healthcare providers, insurance companies, pharmaceutical companies, and food giants dominate the landscape, funneling resources into disease management while neglecting the root causes of chronic illness.
Consider this staggering statistic: 90% of national healthcare spending is for treating and managing preventable diseases, while only 4% goes toward prevention itself. This imbalance reflects a system designed to maintain the status quo rather than promote health.
Meanwhile, the projected cost of chronic diseases in North Carolina from 2015 to 2030 is $1.4 trillion according to The Partnership to Treat Chronic Disease. Think about what could be achieved with those resources — better education, infrastructure, or support for small businesses — if our residents were healthier.
Declining health outcomes
Our healthcare system’s failures extend beyond cost. North Carolina ranks 7th in the nation for teen obesity, according to North Carolina Health News, and the trend is worsening. Teen obesity is a precursor to chronic conditions like diabetes and heart disease, further compounding the financial and health burden on families and taxpayers. Yet, the overwhelming focus remains on expensive treatments instead of prevention, leaving millions of residents on a path toward costly, avoidable illnesses.
Forces driving this broken system
The healthcare crisis is rooted not only in medical practices but also in our food system. Government subsidies for corn, soy, and wheat — accounting for 70% of agricultural support — distort the food supply, making ultra-processed foods cheaper and more prevalent. These heavily subsidized crops lead to ingredients like high-fructose corn syrup, seed oils, and refined flour flooding the market, contributing to obesity and chronic diseases. Removing subsidies would allow healthier, local produce to better compete, fostering a more diverse, nutrient-dense food system that empowers consumers and supports local farmers.
Pharmaceutical companies, while responding to current market needs, are incentivized to prioritize treatment over prevention. Their profits rely on ongoing medication and device sales, which are threatened by healthier populations. In 2023, the pharmaceutical industry spent $378.5 million on lobbying, shaping policies like the Medicare Modernization Act, which prevents Medicare from negotiating drug prices, driving up costs. This system benefits drug companies by focusing on treating illnesses rather than preventing them.
Medical education also falls short in addressing root causes of chronic disease. Although schools like Duke and UNC offer nutrition courses, they’re not mandatory. Recent data shows that 75% of US medical schools lack required clinical nutrition classes, and only 14% of healthcare providers feel confident discussing nutrition with patients. To address chronic diseases effectively, we must make nutrition a core component of medical training, equipping doctors to guide patients toward healthier lifestyles.
A long-standing problem with no action
These issues are not new. In 2004, Carolina Journal reported that obesity was already costing North Carolina taxpayers $1.1 billion annually. Nearly two decades later, those costs have only escalated alongside rates of obesity and chronic disease. The question we must ask is: If not now, when? If we don’t act decisively to unrig this system, we will face even graver consequences for our health, economy, and freedom.
A call to action
The good news is that North Carolinians have more power than we think. Here’s how we can take action:
1. Focus on prevention: Shift healthcare spending toward prevention by incentivizing providers to keep patients healthy, not just treat illnesses. Initiatives that integrate food as medicine — providing access to fresh, whole foods and nutrition counseling — must become a cornerstone of healthcare policy.
2. Support local agriculture: Take advantage of North Carolina’s network of farmers markets to prioritize fresh, local food.
3. Reform medical education: Make nutrition education a mandatory part of medical school curricula. Doctors must be equipped to address the root causes of chronic disease, starting with diet.
4. Empower parents: Parents should advocate for healthier school lunches and avoid buying ultra-processed foods, which currently account for 67% of children’s daily energy intake. These foods — loaded with refined grains, sugars, and seed oils — drive inflammation and are linked to 32 negative health outcomes. Simple changes can make a big difference.
5. Empower consumers: Increase transparency in healthcare and food systems. Consumers should know the true cost of medical procedures, understand how to read labels and the impact of their food choices. Transparency drives competition and accountability.
A hopeful future
North Carolina’s healthcare system may be flawed, but it’s not unchangeable. By embracing free-market principles that prioritize prevention, innovation, and consumer empowerment, we can create a system that truly serves the people.
Food is medicine, and it must become an integral part of our healthcare strategy. Together, we can take back control of our health and build a system that reflects our values of liberty and free markets. The time to act is now — for our health, our economy, and our future.