Pittsburgh needs more insurers
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It has been interesting to observe the public's response to the ongoing clash between Highmark and UPMC. The comments of most citizens, labor groups and employer groups have been predictable and understandable. However, the most interesting reaction, or lack thereof, has been the physician response. Aside from remarks by the president of the Allegheny County Medical Society, there has been little physician comment in our local newspapers.
Doctors should be speaking up, because we have an enormous stake in this dispute. Most of us are concerned about possible disruptions that our patients and our practices may experience. Many of us, particularly in primary care, have long-standing relationships with the people we treat and consider them friends as well as patients. It would be a gut-wrenching experience to lose them.
In my view, health care in Pennsylvania has been disadvantaged by the tactics of Highmark over the last 20 years. Employers have suffered double-digit inflation in their premiums, but physicians have seen little increase in reimbursements. We have trouble recruiting gynecologists, neurosurgeons and orthopaedic surgeons throughout the state, especially in rural areas, because of reimbursement issues.
If it weren't for UPMC's investments in Western Pennsylvania, we would have a great shortage of these crucial specialists here as well. In addition, UPMC has also delivered specialty services, emergency medicine services and telemedicine stroke services to rural and outlying areas in Western Pennsylvania like Bedford and Mercer counties.
Primary care is also struggling because of reimbursement issues. More than 40 percent of primary care physicians get no "pay-for-performance" dollars from Highmark, and this will only get worse for us over the next year with the changes in Highmark's pay-for-performance program.
First Published July 18, 2011 12:00 am
