Hospital executives testified before Congress on April 28 defending their pricing practices, with Republicans citing cases where facility fees at hospital outpatient clinics are nearly double independent surgical centers' charges for the same procedure. The CEOs argued they charge more because hospitals absorb losses from Medicare/Medicaid reimbursement below cost and must treat all patients regardless of ability to pay, while independent clinics can select patients. Democrats largely sidestepped criticism, instead blaming Republican-passed Medicaid cuts for driving affordability crisis. This reflects the ongoing tension in healthcare policy: whether higher hospital prices reflect legitimate cost differences and public obligations, or exploitative consolidation.