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Fábregas: Decision on insurers a bum deal for Allegheny County employees

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Saturday, April 19, 2014, 12:01 a.m.
 

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.

 

 

 
 


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