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Let us talk to powers that be at Highmark

About Luis Fábregas
Picture Luis Fábregas 412-320-7998
Medical Editor
Pittsburgh Tribune-Review

Luis Fábregas is an award-winning reporter who specializes in medical and healthcare issues as a member of the Tribune-Review’s investigations team.

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By Luis Fábregas

Published: Saturday, April 21, 2012

Turns out the state's largest health insurer wants us to meet some of the 20,000 people behind the name Highmark.

That much the insurer's board chairman, Bob Baum, said in full-page newspaper ads last week. The ads, a prelude to a full-blown campaign this summer, are clear evidence that Highmark is in damage control mode after the sudden downfall of CEO Ken Melani. The long-time leader was fired after a fistfight in Oakmont with the husband of his mistress, also a Highmark employee.

While the affair is what everyone keeps talking about, let's go back to the 20,000 workers we'll soon be meeting. Baum, a university professor, is trying to humanize a company that desperately needs to be humanized -- some say way before the Melani debacle. When was the last time you had a pleasant encounter with the person who told you Highmark wasn't going to pay for your surgery?

I'm sure Highmark has a lot of very nice, personable workers. They are our neighbors and friends, the people we see in line at Giant Eagle. You can go to the food court at Fifth Avenue Place and see them eating a salad or turkey sandwich for lunch, just like us.

But quite frankly, the people we want to meet are the Highmark leaders who are making decisions that affect all of us. We want to meet the board directors who hold conference calls and meetings and vote on issues that have a direct impact on our wallets.

I hope we get to meet the person who decides which medication Highmark will pay for, even if it goes against what the doctor ordered. Or the person who decides that one hospital gets paid more than another for the exact same procedure.

Hospitals and health care companies go out of their way to put their employees out front. On its website, UPMC features stories of employees and patients who have been "touched by the power of life changing medicine." They are truly touching and often powerful stories. How can anyone not be inspired by the little girl who couldn't eat and now devours food after an intestinal transplant?

But what about UPMC's CEO and board members• You know, the people who get to decide that UPMC will not sign a contract with Highmark• Who are they and where are they• You can find their names on that same website but that's about it. Good luck trying to ask them a question.

This week, the state insurance department held a hearing about Highmark's proposed acquisition of West Penn Allegheny Health System. Some of the most powerful words came from the front-line workers who care for patients around the clock.

A nurse for LifeFlight, West Penn Allegheny's medical helicopter, spoke about the importance of having two registered nurses on a flight instead of one. She said LifeFlight could be threatened without support from Highmark.

We need to hear from more workers like this, who tell it like it is because they work hard and take pride in what they do. I'm sure the 20,000 workers at Highmark have great stories to tell, too.

But let's not forget there are people who are higher up the food chain that need to show accountability. We need to meet them, too.




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