A health network should not be able to have such a heavy hand

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In the war between Highmark and UPMC, do the combatants share the goal of making UPMC unaffordable for Highmark subscribers? UPMC repeatedly warns that Highmark plans to divert its subscribers from UPMC by making it too costly. Yet UPMC’s impending expulsion of Highmark patients from its network would have the same effect.

Since Highmark publicly pleads for continued in-network access, one is struck by the paradox of Highmark claiming to want what it allegedly does not want. According to UPMC, if in-network access were to be vouchsafed, its rival would just nullify it. But wouldn’t patients then desert Highmark in droves, thus furthering UPMC’s monopolistic ambitions? If UPMC believed its own propaganda it could rely on this abandonment of Highmark, and thereby avoid both flouting the antitrust laws and alienating the populace.

Another seeming paradox is UPMC’s decision to block a major revenue stream, but only as a stratagem for bringing it within its domain. Acting to forgo millions in revenue defies business logic unless your monopoly power ensures that you can recoup that revenue eventually — and cripple a rival in the process.

UPMC admits that its refusal to deal with Highmark is based on the prospect of heightened competition from Highmark’s health care network. And UPMC’s tone-deaf spokesman boasts that the strategy is bearing fruit when a major employer drops Highmark. Clearly such leverage in the insurance market would not exist in the absence of UPMC’s near monopoly in the health care market. That several insurers stand to gain from the displacement of Highmark doesn’t negate the fact that it is the exertion of UPMC’s monopoly power that unduly influences the insurance market

Since companies and individuals evaluating their future insurance choices are undoubtedly taking into account the looming unavailability of UPMC’s network, the injury related to UPMC’s heavy-handed attempt to thwart competition is immediate.

ARTHUR DENBERG
Squirrel Hill


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