The Highmark-UPMC dispute isn't about care

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I read attorney Sandra S. Neuman's March 15 letter "Is Patient Safety a Casualty of the Highmark-UPMC Dispute?" and find it noteworthy that the fight is all about market dominance and has nothing to do with providing high-quality medical care for all of us at lower and more affordable rates. Insurance premiums and costs to patients continue to rise inexorably, and forward-thinking billing geniuses will continue to invent novel devices like the facility fee to increase revenues -- all at the expense of the captive consumers of greater Pittsburgh, and notwithstanding the fact that these mega providers purport to be non-profit entities.

If the Highmark-UPMC dispute is not resolved, the customers of Highmark will be cut off from access to the world-class, cutting-edge facilities and talent at UPMC. Should Highmark and UPMC actually come to some agreement for the benefit of the hapless citizens they are supposed to care for, will UPMC exact higher reimbursements from Highmark, and will that result in more devastating costs to Highmark customers?

We can try to reduce our medical consumption by making healthy lifestyle choices and through preventive care, but the biggest hunk of our health care costs result from unavoidable, unexpected and unpredictable injuries and illnesses -- sometimes catastrophic -- which engender costs we cannot control.

It would seem that the unregulated, for-profit free-market model may not be working in health care, at least not at affordable rates for the ordinary inhabitants of the Highmark, UPMC and West Penn-AGH universe. Perhaps this is one arena where citizens, patients and consumers might benefit from more rather than less government intervention and where corporate motives, as Ms. Neuman pointed out, might be jeopardizing the health, safety and welfare of the captive public.

ART NUSSBAUM, M.D.
McCandless


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