More than 300 people packed a public hearing last week to debate whether Mission Hospital in Asheville is an overbearing monopoly and is unfairly squeezing out smaller hospitals in the region.

Doctors, hospital leaders and patients from across Western North Carolina gave passionate speeches in hopes of swaying a state committee investigating the issue.

At issue: whether anti-trust regulations limiting Mission’s influence should be tighter, or done away with.

“Mission must have the freedom to serve. It must have the freedom to compete for patients,” said Ron Paulus, the CEO of Mission. “It means letting patients and physicians choose where they go, who to align with, and letting performance on quality determine the winners and losers, not government regulation.”

But opponents portrayed Mission as a predator and bully, gobbling up smaller hospitals and buying doctors’ practices to funnel more and more patients to its mothership in Asheville, weakening the availability of health care in people’s home communities around the mountains.

“Mission success is inversely proportional to the success of the region’s smaller hospitals,” said Jason Wells, vice president of Park Ridge hospital in Hendersonville.

“When Mission gains market share, someone else has to lose market share.”