Legislators listen to the public on UPMC, Highmark dispute

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Joseph Angelelli -- son of a retired Highmark employee, married to a UPMC employee, currently doing research with UPMC -- says he doesn't want to pick sides in the showdown between the two Pittsburgh health giants.

But at Friday's meeting of the state Senate Democratic Policy Committee, Mr. Angelelli, director and professor of health services administration at Robert Morris University, said "something has to be done" from a legislative or regulatory standpoint to force UPMC and Highmark into a working business partnership.

"This is a public health issue at its core," he said.

Highmark customers who find themselves locked out of most of the UPMC hospital network come Jan. 1, as UPMC is threatening, will in some cases see long-standing relationships with their doctors and specialists severed.

"This contract dispute is sure to create many preventable errors" and emergency room visits, he said. And the threatened divorce would be an anathema to the spirit in which UPMC Mercy, UPMC St. Margaret, UPMC Montefiore and other UPMC hospitals were founded.

Also invited to testify Friday was Dennis Gabos, a UPMC physician -- "for the present," he joked -- whose widely circulated opinion piece in the Pittsburgh Post-Gazette criticized top UPMC management for "waging battle against citizens, patients and its own health care professionals."

Those legislators who would rather let the free market handle the dispute "plainly don't comprehend the magnitude of the injustice and harm" wrought by UPMC's overlords. (UPMC officials were invited to the session, senators said, but did not attend.)

One of those harmed by the contract fissures was Lynn Kiesel, a spina bifida patient whose mother, Sandy, testified on her behalf. She said her daughter was denied a prescribed treatment at UPMC Mercy because she carried Highmark's Community Blue product, which does not include UPMC among its in-network facilities.

She was "escorted out of the hospital," and into the ER, Sandy Kiesel said. She ended up buying a UPMC Health Plan policy, on top of her Community Blue policy, to keep her UPMC access.

In a statement delivered to senators, Deborah Rice-Johnson, president of Highmark health plans, said that severing the long-standing relationship between the two organizations would "lead to higher costs, greater inefficiencies [and] fragmented care" in the Pittsburgh region.

Senators spent much of the hearing kicking around tangentially related policy ideas. Sen. Jim Ferlo, D-Highland Park, said the bickering between the two health systems demonstrates the need for a single-payer system.

Sens. Jay Costa, D-Forest Hills, and Randy Vulakovich, R-Shaler, as well as Rep. Dan Frankel, D-Squirrel Hill, continued to campaign for "any willing insurer" legislation that would compel large, integrated health systems to grant access to any insurance company that wishes to enter into such a contract.


Bill Toland: btoland@post-gazette.com or 412-263-2625.

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