If premature state legislation were a medical condition, I'd perhaps be a carrier. I spent a good part of Wednesday trying to get people to talk about a proposed state law that would force Highmark and UPMC to play nice together.
The bill hasn't even been written yet. As I wrote last week, it has gone no further than a memo to state House members. But that memo from Rep. Jim Christiana, R-Beaver, backed by Rep. Dan Frankel, D-Squirrel Hill, suggests that the state should "require hospitals operating as part of an integrated delivery network to contract with any willing insurer."
In other words, you could take your Highmark insurance to any UPMC hospital. You could take your UPMC Health Plan insurance to any hospital under the Highmark umbrella. They'd be honored. The only potential downside would be that those dueling attack ads by the rival "nonprofit" behemoths might end, and so we'd never know what diner their mouthpieces might have visited next.
Highmark favors this concept, and UPMC does not. But trying to get a governor and a mayor to comment much about a hypothetical state law is tough, even when you manage to confront them in the wild.
Both Gov. Tom Corbett and Mayor Luke Ravenstahl were at a groundbreaking ceremony Wednesday for the Gardens at Market Square, an 18-story building in Downtown that will have offices, a Hilton Garden Inn, a parking garage, restaurants and retail space.
"It's premature to talk about this," Mr. Corbett said of the proposed health care legislation.
He'd have to see the bill to determine its impact statewide. Hospitals across the state "are watching what's happening here," he said, and the trick will be crafting a law that addresses the problem in greater Pittsburgh without adversely impacting hospitals outside Western Pennsylvania.
"Not that I don't have thoughts," Mr. Corbett said, but he won't be sharing them until legislators craft a bill.
Mr. Ravenstahl went a little further.
"It's great to see some action on the state level," he said. "Both sides seem to be dug in pretty deep."
He'd prefer that Highmark and UPMC get together without being forced. This bill "expects the worst," he said, but "the bottom line is we want to see a deal get done."
It won't if UPMC has anything to say about it. UPMC spokesman Paul Wood said "contracts are meant to expire" and a law such as this would take away any leverage that hospitals have and shift it all to the insurer. The insurer could get any rate it liked, he said.
"There is a real price war going on in the health insurance marketplace thanks entirely to UPMC signing market competitive contracts with other insurers [such as Aetna, Cigna, UnitedHealthcare and HealthAmerica] that allows them to compete head-to-head with Highmark," Mr. Wood wrote in an email.
Under the "Highmark insurance monopoly," he said, insurance premiums soared. Now, he says, they've moderated.
"Competition, not forced contracts or other means of price regulation, is the way to keep that ball rolling," Mr. Wood said.
Highmark counters by saying that underlying medical costs are the main driver of insurance premium increases. In a prepared statement, it said it's those other guys who are playing Monopoly:
"A number of national studies have concluded that the trend toward consolidation of health care providers is raising the overall cost of health care, nationally and in Pennsylvania. Today, in Pennsylvania, there is virtually no effective way to control the impact of business conducted by unchecked, consolidated provider systems that could harm consumers.
"Highmark will continue to work with state policy makers to protect consumers from the inappropriate use of market power by large, consolidated provider systems."
If that's true, Highmark is doing that in part by becoming a large, consolidated provider system itself. Its Allegheny Health Network arm is UPMC's nightmare.
So we know at least two things:
1) Highmark and UPMC are highly unlikely to come to a compromise on their own.
2) There is no immediate cure for the attack ad epidemic.
Brian O'Neill: firstname.lastname@example.org or 412-263-1947.