Fábregas: Decision on insurers a bum deal for Allegheny County employees
Pity Allegheny County employees.
Just like that, their access to UPMC hospitals will come with a higher price come the end of the year.
So said County Executive Rich Fitzgerald, who this week announced that the county's 6,700 employees get to keep their Highmark insurance cards regardless of what happens with the big UPMC-Highmark blowup.
The decision means county employees won't be able to get care at UPMC at in-network rates when its contract with Highmark ends in December.
Fitzgerald's logic is that he's sending a message to UPMC and chiding its leaders for refusing to negotiate a reimbursement contract with Highmark. I suppose he's also telling UPMC that the county can live without the region's largest employer.
The losers in all of this, of course, are county employees and their dependents — 15,000 people — even though they will have access to Highmark-owned Allegheny Health Network. Those hospitals are filled with some of the best health care workers and doctors in the country. Heck, some of them have been recruited from UPMC.
As I've argued on these pages for months, if not years, the issue here is choice and competition. The freedom to get health care where we want doesn't come by government forcing two entities into a relationship.
It'd be like forcing McDonald's to use Heinz ketchup in its Big Macs. If you recall, McDonald's dropped Heinz when the ketchup maker hired the CEO of rival Burger King. No one forced McDonald's to go back to Heinz, did they?
Fitzgerald, in his desire to shoot off a message to the execs in the top of the U.S. Steel Tower, seems to have forgotten that employees want — and expect — choice. That much we've heard from surveys that show more than half of the region's big employers will offer employees a choice of Highmark and some other plan that includes in-network access to UPMC.
The county says it didn't select Highmark based on cost alone, even though it offered the lowest bid — $85 million for 2013. By comparison, UPMC Health Plan provided a bid of $88 million and Aetna one for $92 million.
There is, of course, some good news out of this. Taxpayers will see a savings of $10 million that Fitzgerald said Highmark will discount in premium payments and administrative costs this year and in 2015. That's a pretty significant windfall, if you ask me. Will taxpayers benefit from it? Or is that the price to pay for sending a message to UPMC?
In deciding to stick with Highmark, county officials never went back to Aetna or UPMC Health Plan to ask whether they'd offer a better deal. They say they didn't because they're in the midst of a contract. But what's wrong with offering employees another insurance option, much like the city of Pittsburgh is doing?
There's a new competitive health care landscape in Western Pennsylvania. Its beauty is in the fact that Highmark was basically forced to give the county that $10 million discount. If other insurers want to drum up some of these high-profile contracts, they too will have to lower their prices. Quite frankly, it's hard to argue with health care that comes at a lower price.
Luis Fábregas is Trib Total Media's medical editor.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Pittsburgh police break up customer fights over Air Jordan 11 shoes
- Penguins missing Martin, Ehrhoff, Adams; prized prospect Pouliot called up
- North Huntingdon residents warned about vehicle break-ins
- Coal ash sites have tainted hundreds of waterways, aquifers
- Undersized Beachum quietly excels at 1 of game’s pivotal positions
- Despite intimidation, women still passionate about video games
- Steelers notebook: Polamalu, Taylor unlikely to play, Harrison ‘ready’
- LCB ruling could mean home-delivered beer in Pa.
- Michigan State defensive coordinator a Pitt coaching candidate
- As smokers seek Cuban cigars, retailers point to trade embargo
- EPA says it won’t regulate coal ash as hazardous waste