UPMC and Highmark must come to terms

There is no free market in health care; sometimes government has to intervene

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This article was submitted on behalf of state Sens. Jay Costa, D-Forest Hills, and Randy Vulakovich, R-Shaler, and state Reps. Jim Christiana, R-Beaver, and Dan Frankel, D-Squirrel Hill, who are sponsoring bills that would require hospitals and physicians operating as part of an integrated delivery network to contract with any willing insurer.

Simplifying the contract dispute between Highmark and UPMC to a question of Company A selling widgets — or french fries! — to Company B, as in the Post-Gazette Perspectives piece published June 5, “Let UPMC and Highmark Argue It Out,” does an incredible disservice to the people in our community, the ultimate “purchaser” of these services.

Patients in Western Pennsylvania aren’t buying widgets from UPMC and Highmark; they’re buying health care. That means they’re buying peace of mind, expertise and relationships. They’re buying relief, trust and hope. Quite simply, health care is unique.

Doctors know it. That’s why 80 percent of the members of the Allegheny County Medical Society said in a poll in 2011 that if the contract between Highmark and UPMC isn’t renewed, patients would suffer.

Patients know it. That’s why we, as legislators, receive heartbreaking calls from people worried that they’re going to lose the care of their long-time doctors if UPMC no longer accepts payment from Highmark at most of its facilities.

The government knows it. That’s why so many health care companies are “purely public charities.” They receive tremendous tax benefits and government funds under the premise that their primary mission is to care for the community.

Philanthropists know it. That’s why foundations and individuals give millions of dollars every year to support our local hospitals.

And most health care economists know it. They point out that health care is very different than most other businesses. The person who goes to the doctor isn’t usually the same person who pays for the visit (the insurer pays most of that bill). And, more importantly, people who are really sick can’t choose not to go to a doctor because they think it costs too much. Anyone who has ever broken a leg or loved someone battling cancer can tell you that.

People in and out of government generally agree that patients deserve to have their health care reasonably regulated. They want to know that someone performing surgery has training. The want to know the government makes sure hospitals are safe. And in this case, many people feel strongly that the breach between Highmark and UPMC isn’t just a dispute between two corporations, but rather a rift that will deny people access to the very institutions that they helped build.

That’s why we have sponsored legislation to ensure that no hospital system can decide to simply refuse an insurance company because it’s not part of their business model. And it’s also why, in an era of heightened partisanship, this issue draws support from both Republicans and Democrats.

Health care is not just another business. Health care is unique.

Patients expect us to treat it that way.


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