The PG needs some historical perspective of insurers' impasse

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I have followed with interest the Post-Gazette's coverage of the ongoing impasse between Highmark and UPMC.

Having worked for both sides, insurers and providers, I have witnessed the evolution of third-party reimbursement as it moved from a cost-plus basis to the implementation of diagnosis-related groups and their current variations.

Your newspaper's bias and lack of historical perspective has amused me. On Sept. 16, however, your editorial cartoon just made me angry.

The Post-Gazette does a disservice by failing to inform readers of the historical events that led UPMC to launch its own health care plan. In the 1970s and 1980s, Blue Cross-Blue Shield plans held a near monopoly on health insurance across most of the United States. All providers here were strong-armed by Blue Cross to accept insufficient reimbursement while Blue Cross premium costs increased and its "reserves" bloated to billions of dollars. Finally UPMC saw an opportunity to utilize market forces to offset the "Blues' " monopolistic practices by forming its own health insurance plan.

You contribute to the misinformation campaign that UPMC will "shut out" all Highmark policyholders, when the impasse doesn't involve most of Highmark's product lines. With billions in "reserves," it is Highmark's obligation to subsidize a low-cost loss-leader rather than insisting that UPMC do so by accepting lower reimbursement.

Finally, the Post-Gazette should at least mention the ongoing personal battle between the UPMC management team and the former UPMC managers at Highmark. Those ego battles are a subtle but significant factor in the failure to resolve the conflict.

If you believe all the fault lies with UPMC, you need to do a little historical research. Remember, there are three sides to every story: your side, my side and what really happened. A great newspaper should report what really happened.




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