Sunday, April 1, 2012

While Chief Justice Roberts Appoints Himself a Member of Congress in the Health Care Debate, Here’s Look at Pittsburgh’s Real World Problem Involving Highmark and University of Pittsburgh Medical Center

Exhibit A Why Leaving Health Care to Private Competition Will Not Work

At the Supreme Court in the oral arguments over the legality of the health care legislation Chief Justice Roberts inadvertently revealed how Court Conservatives really view their roles on the Court.  That view is that as Conservative Justices they are super legislators, imposing their views of policy on the nation.  Here is the Chief Justice

The chief justice said many provisions in the law were included as sweeteners to help enact the less-popular individual mandate. Without those provisions, Congress "would not have been able to cobble together the votes to get it approved," Chief Justice Roberts said.

Of course that is totally irrelevant as far as the legality of the law is concerned, but totally appropriate if a judge considers his job to implement public policy serving as sort of a one person legislature, which of course is what arrogant Supreme Court Justices do.

Back in the real world the health care situation in Pittsburgh is illustrating the difficulty of allowing the private sector to function without regulation and expecting it to deliver quality health care at a reasonable cost.  In Pittsburgh, Highmark who is an insurance company has purchased a medical complex with the idea that by combining insurance and care they can save money.  That is a very valid principle.

The problem is that the dominant health care provider in the area, the University of Pittsburgh Medical Center sees this as a competitive threat.  Consequently they want to cut off Highmark from using UPMC.

In the broader dispute, focused on privately insured people, Mr. Romoff says he won't tie up with Highmark because the insurer will seek to steer patients toward West Penn Allegheny, and he argues that the two giants should compete, not cooperate. Patients can assure access to UPMC by switching health plans, he says. "We can't contract with Highmark," he says. "It would be from UPMC's point of view suicidal."

This is idiocy.  Both of these groups are non-profits.  Their focus should be on bringing the highest quality medical care to the most people at the lowest possible cost.  They both directly and indirectly receive billions from the public.  This is a prime example of why health care cannot be left to the private sector, why competition may result in less care and higher costs without government regulations.

Make no mistake, this is diverting resources and attention away from health care.  And producing an ugly process that may result in diminution of services.

Their fight has played out through advertising campaigns, a legal battle and lobbying over bills that could grant state regulators the power to keep Highmark and UPMC yoked to their current, expiring deal for extra years. Doctors are being pressed to choose sides and fear losing patients. Employers are bracing for the possibility that they will have to change their benefits packages and pay higher health costs down the road.

And even in Pennsylvania, with its Republican controlled state government the Governor and the legislature do not seem disposed to allow the conflict to work itself out by denying Highmark subscribers access to UPMC, the top medical center in the area.  They have given strong signs they will intervene if the two organizations cannot settle the issue for the benefit of the public.

As for patients, there is this person.

Trish Wyckoff is struggling with stage-four breast cancer, but now the 53-year-old Pittsburgh resident has another worry: a possible divorce between the hospital system that is treating her, the University of Pittsburgh Medical Center, and Highmark Inc., the health insurer that pays for her care. If the two companies can't agree, she fears she won't be able to keep seeing the doctors who she believes are keeping her alive.

"We are absolutely stuck in the middle," she says. "This is a really scary time."

But unregulated competition in the health care industry really doesn’t care about her.  And of course neither do ideologues who sole goal is to remake the world according to what they see fit, patient care and well being be damned.

1 comment:

  1. This is a validation of the Krugman single payer concept. The problems of the Highmark CEO ($4m/yr.) will distract the argument and the outcome of this dispute, unfortunately.