Activists Charge Contract Dispute between Two Nonprofits Places Vulnerable at Risk

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April 30, 2012; Source: Essential Public Radio

In Pittsburgh, Pa., contract talks between a nonprofit health network, UPMC (the largest health care provider in the area), and Highmark, a nonprofit health insurer in the state, have broken down. Now, health care consumers are out in the street demanding legislative intervention. If the contract negotiations do not work out, tens of thousands would have to pay much more to access their UPMC health care providers, and that is not acceptable, according to the Coalition for Health Care Choice.

A rally held on Monday saw most of the speakers blaming UPMC for the breakdown. Leo Gerard, the president of United Steelworkers, asserts that UMPC is engaging in, “economic blackmail…This is simply them trying to use their regional strength of having acquired so many hospitals to try and beat not only Highmark, but us, into submission.” Speakers for patients with mental health needs and disabilities focused particularly on the problem the breakdown would cause for them in terms of interruptions of their relationships with trusted caregivers. “It’s literally taken decades for me to cultivate a relationship with my physicians,” said Anne Nalepa of the Three Rivers Center for Independent Living. “I don’t have the time or the money to start over.”

Apparently legislation has been drafted that would ensure access to some of UPMC’s facilities are available to those carrying any insurance. This article asserts that although legislators are not “taking sides,” they do acknowledge UPMC’s $3 billion surplus and “aggressive business tactics.” –Ruth McCambridge

  • Richard & Kathy Myers

    We have a 12-year old special needs daughter for whom we have sought the best care available in our area. In addition, we deal with Children’s Hospital of Pittsburgh, which is owned by UPMC. We currently have UPMC insurance as her secondary insurance and Highmark as her primary insurance. Her medical providers are split between Highmark hospital affiliates and UPMC. This move will force us to find new medical providers so all are affiliated with one or the other. In addition to narrowing our medical providers, they are cutting back services provided to special needs children.

    My daughter has an intractable seizure disorder whereby she goes into non-convulsive status epilepticus (a continual non-convulsive seizure) frequently. Thanks to her neurologist a CHP, we found a medication regiment of 3 seizure medications with the addition of an emergency medication for a seizure lasting more than 5 minutes that has worked for 2 1/2 years. In this economy, both parents need to work to support a family and UPMC was paying for private duty nursing services to administer my daughter’s medications as well as monitor for seizures. UPMC and the Department of Public Welfare of PA has now decided we no longer require this service since she has been seizure-free for 2 1/2 years. With her diagnosis, it is not a question of “IF”, it is a matter of “WHEN & HOW SEVERE” will the next seizure be. We would like to know if UPMC is going to assume the responsibility and pay for the ambulance to our local hospital which is not UPMC-owned, then the life-flight from the local hospital to CHP and all of the medical bills and possibly the funeral costs if a seizure should occur under their suggested service of a home health aide who cannot administer her emergency medication prior to an ambulance arriving at our country home at least 1/2 hour from help.

    We are very unhappy with insurance in general and the extreme changes and cutbacks being placed on those of us who pay a fortune for the insurance to begin with.