The article addresses the issue of whether it is justified to maintain the status of local government units (LGUs) as entities establishing independent public healthcare institutions (SPZOZ). The author, through an analysis of the applicable legal regulations, points to the lack of clear legal grounds for assigning LGUs the task of organizing and financing healthcare services-placing particular emphasis on the financing aspect. The healthcare system in Poland is based on funding from the National Health Fund, which calls into question the appropriateness of holding LGUs responsible for SPZOZs. The article also discusses the consequences of the current legal framework, including financial opacity and unclear division of competences, which may lead to systemic inconsistencies. Alternative solutions are proposed, such as transferring the function of establishing SPZOZs to government administration bodies or clarifying the regulations in an unambiguous manner - with emphasis on the latter. The author argues that regardless of the reform path chosen, it is essential to uphold the principle of legality and to increase transparency in the financing of the healthcare system.