Nicholas Theis: UPMC workers & the need for a union

Ensuring everyone has access to UPMC’s nonprofit hospitals should be a no-brainer, yet both Pittsburgh City Council and the mayor have failed in recent years to hear their constituents out, or use their powers to protect them.

Now, tens of thousands of Pennsylvanians face the prospect of being shut out of UPMC hospitals by the end of June.

As we await the court’s decision on the Pennsylvania attorney general’s much-needed filing to protect patients — and potentially save their lives — I want to ask people to keep in mind the tens of thousands more who will still be shut in: the UPMC workforce.

UPMC employs 80,000 people in the state, and for me and my colleagues, UPMC insurance is our only option. While it’s true that many employers offer their employees only one health care plan, a very particular conflict arises when your employer also sets the prices of both the insurance and the health care itself.

UPMC decides what to charge us for physician visits, sets the costs of our visits to its hospitals and bills our health plan, which in turn bills employees for premiums, co-pays, deductibles and uncovered services. It’s not uncommon for UPMC employees to find arbitrarily high provider costs for mundane medical procedures (that UPMC then arbitrarily discounts for itself), only to leave its employees with bills they can’t possibly pay with a single full-time job at UPMC.

One of my co-workers had an issue that required him to stay in a UPMC hospital for several days. UPMC charged $225,000, gave UPMC Healthplan a 92% discount and left my co-worker with a bill for $2,500.

You might ask, “Isn’t going from $200,000 to $2,500 reasonable?” But the real question is, “Where do these numbers even come from?” UPMC sets the prices and the discounts it gives itself, so what he owes can in theory be anything. What would he have paid if the so-called charity hospital had said his care was worth $325,000? Or $25,000?

Remember that UPMC also sets his wages. UPMC knows full well that he makes about $14 an hour; $2,500 is a month’s wages. Because of his income status, he is eligible for free care under UPMC’s financial aid guidelines. But UPMC, which bills itself a charitable institution, devotes only about as much of its revenue to charity as our region’s for-profit institutions.

UPMC employees’ ability to pay down our bills, maintain our credit and escape the stress of collections is determined by the same entity that tells us what medical services and our insurance cost. Nowhere in this equation do employees have a voice. When we have tried to organize or form a union, we have been met with aggressive, unlawful tactics at every step, including intimidation and wrongful termination.

In 2014, a federal judge noted that UPMC’s illegal behavior was part of a pattern of “egregious and widespread misconduct” against workers’ protected organizing rights. UPMC’s treatment of its workers has led to several strikes in recent years, all of them to protest UPMC’s ongoing unfair labor practices.

As the largest health care provider and employer in Western Pennsylvania, UPMC has the power to substantially improve the standard of living for so many. It simply chooses to be a bully instead. With a union, the 80,000 working people who run UPMC day-to-day would have a voice not just for better working conditions but for a fair and accountable UPMC for everyone.

Nicholas Theis is a research principal at UPMC Western Psychiatric Hospital.