Framing the Dialogue

Free Market For Me

king kongAlmost two years ago I wrote a post about a battle between two behemoths in Pennsylvania.  Highmark is the largest health insurance provider in Pennsylvania and the University of Pittsburgh Medical Center (UPMC) is one of the largest health care providers in the state and certainly the largest in the western part of the state.  A summary of the battle is that UPMC started offering their own health insurance years ago so they got into the insurance business.  A few years ago Highmark started to purchase some failing hospital in the Pittsburgh area.  These hospitals were competition for UPMC.  UMPC decided that it would, after an existing agreement expired, no longer accept Highmark health insurance at its facilities.  I think that I mentioned that Highmark is the largest insurance provider and that UMPC is pretty much the only game in town in the western part of the state.

There was a stop-gap settlement and the agreement was extended until the end of 2014, but the battle roars on.  In our area both sides have taken to the airwaves to plead their case to the public.  Neither side seems to want to give in and I can understand both sides of the issue.  My issue has always been that the ones who will ultimately suffer are the patients.  I like my health insurance (Highmark) and I almost always go to UPMC facilities.  They are both top notch.

Two members of the Pa House of Representatives have introduced a bill that would essentially force the health care giants to go along and to get along.  The latest tactic reported in the local papers is that UMPC has asked employees to contact their legislators about the fight.  They want their employees to lobby for their cause.  UMPC is reported to be the largest private employer in the state with an estimated 63,000 employees.

I don’t really have a dog in this fight.  My employer does not offer a UPMC option, but my guess is that they will soon and if it goes UPMC’s way that’s what I’ll have to choose.  The INSANE news about this latest tactic is something UMPC put in an email to employees about the pending legislation;

“This legislation is government intervention at its worst, with a legislator choosing a winner in what should be a competitive market of hospitals and insurers.”

It seems absolutely hypocritical that UPMC, an organization that enjoys great benefit by being a tax-exempt “non-profit,” is calling for free market principles.  Imagine if you can that you are a business owner and you have property from which to run said business.  Imagine again the additional “profit” that you would enjoy if you had to pay ZERO property taxes because you were exempt.  It boggles my mind that a huge organization that avoids paying probably millions of dollars in property taxes now calls for a competitive market.

I would expect their competition in the “mini-clinic” market to start the drum beat for open competition.  I am going to guess that the CVS’ and Walgreens’ of the world have to pay property taxes on their buildings and clinics.  Maybe UPMC also does for their versions.  I’ll never know.

There are probably far too many lawyers involved and the practical solution eludes them all.  Unlike lawyers, doctors and all health care providers must;

Primum non nocere  (“first, do no harm.”)

That simple declaration seems to be missing from the battle.

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