The new round of sniping between UPMC and Highmark is a sobering reminder that Western Pennsylvania's health care war may have gone quiet, but it hasn't gone away. The fight is over whether people and businesses will be able to keep choice on medical care and health insurance, or be doomed to a high-priced UPMC monopoly that eventually controls both.
It's just that simple.
The latest salvo, fired by UPMC last month, was a four-page message to elected officials and others that tries to heap doubt on Highmark's request for approval from the state Insurance Department for a proposed affiliation with the West Penn Allegheny Health System. That potential merger, like the integrated network already linking UPMC's 15 hospitals and UPMC Health Plan, would maintain competition.
The marriage of financially ailing WPAHS and reserve-rich Highmark, the region's dominant health insurer, would sustain Allegheny General Hospital, West Penn Hospital, Forbes Regional Hospital, Canonsburg General Hospital, Allegheny Valley Hospital, Forbes Hospice and their medical affiliates, not to mention the system's 12,000 jobs.
UPMC professes to want competition, but its actions suggest nothing of the sort. The proof is its refusal to extend beyond 2014 the contract that gives Highmark customers access to the UPMC network. By the same token, WPAHS has for years sought a deal to give customers of UPMC Health Plan access to its facilities, but UPMC has refused that, too. In other words, it's UPMC that wants to be a closed shop.
It's just that clear.
Now UPMC is pushing the outlandish notion that Highmark doesn't really want a long-term agreement with UPMC -- the supposed evidence being that the plan submitted by Highmark to the insurance department is not predicated on a renewed contract. UPMC's ridiculous contention is refuted by all public statements by Highmark officials, the latest of which came last week in a public position paper.
"Highmark's proposed integrated delivery network and a long-term contract with UPMC are not inconsistent objectives; they are in the best interests of the Western Pennsylvania community," the Highmark paper said.
The ploy is typical UPMC. It would have condemned any financial proposal Highmark had put before the state. If Highmark had submitted a plan that presumed a renewal of the UPMC pact, UPMC would have moaned (legitimately, in that case) that no such agreement has been reached.
But Highmark instead submitted a plan based on the present reality -- UPMC's repeated declarations that it will not renew with Highmark. Despite that, UPMC faults the insurance company because it "has now predicated the future viability of WPAHS entirely on the absence of a contract with UPMC after 2014."
UPMC can't have it both ways. Its personnel and facilities provide high-quality care, but its corporate strategy is hostile toward consumer choice.
Either it wants Highmark and WPAHS to merge, or it doesn't. Either it wants Highmark customers to have access to UPMC care, or it doesn't.
By constantly raising flags to Highmark's rescue of WPAHS, UPMC signals that it wants this market to itself.
It's just that frightening.