Editorial asks Gov. Corbett to weigh in on UPMC v. Highmark

Dear Gov. Corbett: We’re about to lose our affordable UPMC access …

Sunday, October 23, 2011

Pittsburgh Post-Gazette

Yet we never thought it could happen. Not in Pittsburgh, the home of so much world-class medicine. The city where sheiks and princes come to be healed. The place where relatives and friends drive in from out of state for cancer care, children’s surgery and specialty treatment not available where they live.

We used to take pride in having quality care that was close at hand, so much so that we’ve given willingly every year to Children’s Hospital, we’ve been happy to see taxpayer-provided grants go to UPMC facilities and we’ve watched our well-endowed neighbors offer tremendous philanthropy to build new UPMC centers.

But now we’re caught between two feuding giants — UPMC, which controls most of the region’s health care, and Highmark, which issues most of the region’s health insurance — and it’s the average folks of Western Pennsylvania who are about to be trampled. That’s because UPMC, its CEO Jeffrey Romoff, its executive officers and supposedly its 24 directors are against negotiating a new service agreement with Highmark.

After June 30, when the current 10-year contract lapses, we, as Highmark customers, will not be entitled to in-network access at most of UPMC’s 20 hospitals. A one-year rollout, or grace period, after that will let us continue to receive affordable care for 12 more months under our Highmark plans. UPMC insists, however, that the grace doesn’t apply to our relationships with its doctors. All those years of care, treatment and support — “life changing medicine” as UPMC calls it — will end eight months from now, says the hospital network.

Highmark is willing to talk about reaching a new agreement, but all UPMC wants to discuss is terms of the divorce. Well, we’re not interested. Nor do we buy the Romoff Remedy: Just switch health plans, which the $4-million-a-year executive says plenty of people do anyway “once a year.”

We won’t because we helped build the empire that is UPMC and our premiums helped create the near-monopoly that is Highmark. As so-called nonprofits under the state public charities law, they each had a bundle left after expenses last year — $406 million at UPMC and $462 million at Highmark. The way we see it, those profits, reaped from large companies and small firms, rich and poor families alike, oblige them to work things out.

Trouble is, UPMC doesn’t see it that way. That’s why Pennsylvanians must turn to their elected officials. Various members of the Legislature, thank goodness, have gotten active on the UPMC-Highmark split to try to drive the parties back to negotiations.

Rep. Dan Frankel, a Squirrel Hill Democrat, has introduced a bill that would require binding arbitration if UPMC and Highmark fail to reach an agreement covering Children’s Hospital, Magee-Womens Hospital, Hillman Cancer Center, Western Psychiatric, UPMC cancer centers and the health care workers who provide care at those facilities. The bill has 73 co-sponsors — 57 Democrats and 16 Republicans — who blanket Western Pennsylvania.

Rep. Tony DeLuca, D-Penn Hills, has a bill with bipartisan support from 60 co-sponsors that would give the state insurance commissioner power to order that a contract between a feuding hospital and insurer be continued if it were in the public’s interest.

These bills are unusual. But the pressure is critical, necessary and a reminder to UPMC that it can’t profess to serve patients in one breath, then treat them like chattel in the next. Here’s where you come in, Gov. Corbett.

It’s time for you to use the power of your office. It’s why you were elected, after all. We know that, as a Republican, it goes against your grain to interfere in what some might call a business dispute. But this is no mere disagreement — it’s a public war, and a war on the public, that will take its toll on the medical treatment of innocent people, that makes this region look dysfunctional on how its health care and health insurance intersect and that will hurt Pennsylvania from an economic development standpoint.

If this kind of crisis, unfolding in your city, doesn’t call for a governor’s intervention, then we can’t imagine one that does. Gov. Corbett, it’s up to you to bring them to the table, for the health of Pittsburgh, for the sake of Pennsylvania.

Sincerely wishing it weren’t true,

3 million Highmark customers

Read more:

http://www.post-gazette.com/pg/11296/1183974-192-0.stm?cmpid=newspanel6

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