Reporting Jon Delano
PITTSBURGH (KDKA) — Top officials at Highmark, led by Dr. Kenneth Melani, and UPMC, led by Jeffrey Romoff, testified before a Senate banking committee today looking at ways to keep UPMC doctors and facilities open to Highmark customers after a contract expires in June 2013.
Following Romoff’s testimony, KDKA Money Editor Jon Delano confronted him with a question many health consumers are asking.
Delano: “Tens of thousands of Highmark subscribers love their UPMC doctors and their UPMC facilities. How can you deny them the opportunity — at the same cost — to use those facilities and doctors?”
Romoff: “They will have opportunities at lesser cost to use those facilities. They will have five health plans, insurance companies, to use to get to UPMC facilities.”
In Romoff’s view, it’s all pretty simple. If you want UPMC doctors, drop Highmark insurance and sign up with another insurance company.
“I think the battle here is very hard to understand, and the public does it’s very best to do so,” says Romoff.
Delano: “But from the public perception, these are just two giant monopolies fighting each other and the public is getting lost in the middle. Do you see it that way?”
Romoff: “I see these as two giant organizations that are trying to do the best for the public, and there is not an opportunity for us to do it together.”
So should the government order Highmark and UPMC to reach an agreement beneficial to the public?
“I think it would be a very unwise move,” says Romoff.
Absolutely, says Highmark’s Melani.
“We need legislation that prevents this chaos from ever happening again for any insurer across the state with any provider across the state,” insists Melani.
Melani wants legislation to give the state power to order arbitration between Highmark and UPMC, a position that Romoff rejected.
Delano: “What do you want state government to do in this situation?”
Romoff: “Very little. I think state government should assure that this transition period is orderly, should assure that we can get from Point A to Point B in a way that does no harm to any patient and not much more than that.”
But Melani says it’s Highmark that in saving West Penn Hospital is acting in the public interest.
As for UPMC, he notes, “Mr. Romoff is self-centered for his own purposes. He is centrally focused on his own corporate entity. He is not looking at the best interests of the people in the community. He doesn’t want competition.”
Romoff insists there’s nothing personal here — it’s just business.
Delano: “There’s no room for movement on your part — if folks want to use UPMC and UPMC facilities, they have to go to a different insurer than Highmark?”
Romoff: “Ultimately, that will be the case.”
In the meantime, state lawmakers are looking at legislation to force a cooling off period, mediation or arbitration on the parties.
Highmark customers do not lose access to UPMC until June of 2013 — and some facilities, like Children’s Hospital, will remain covered for years to come.