June 13th, 2018
Late last year, the University of Pittsburgh Medical Center proposed a $2 billion expansion plan to build three more specialty hospitals in Pittsburgh. UPMC officials hailed the expansion as a “transformative” move to “change health care as we know it” and create the “hospital of the future.”
However, UPMC workers, Pittsburgh community members, and others are pushing back against the health giant, arguing that a hospital with tax-exempt non-profit status should be doing more to improve the health of underserved Pennsylvania residents, instead of expanding their market share.
In an editorial on PennLive, Lown Institute leaders Shannon Brownlee and Dr. Vikas Saini explain how the UPMC expansion is part of a growing trend of hospitals putting profits over patients – and reaping taxpayer money while doing it.
As a non-profit, UPMC receives about $200 million a year in tax breaks for providing medical services and other support to benefit community health. Yet, the new UPMC hospitals are clearly meant to attract patients from out-of-state for specialty care like vision and cancer care, not address the noted health issues of Allegheny County residents, including obesity, diabetes, asthma, and alcohol abuse.
“Pittsburgh needs more community clinics, more access to primary care for its residents, and more investment in nutrition and fitness programs,” write Brownlee and Saini, “That’s not what UPMC is investing in.”
Investing in lucrative specialty care rather than community health is not new for large hospital systems. The Cleveland Clinic has been criticized for letting the surrounding city fall into disrepair and ill health while expanding to attract international patients. Boston is a mecca of medicine, but its elite hospitals systematically exclude the city’s low-income African American residents.
Hospital consolidation and expansion are particularly concerning, because hospitals can charge more for services the larger they get. A recent report from the Health Care Pricing Project found that prices of health care services in markets with only one hospital were 12 percent higher than those in markets with four or more rivals. Last year when the Boston Children’s Hospital announced their expansion plan, the MA Health Policy Commission estimated that the expansion could raise Massachusetts healthcare spending by $8.5 – $18 million, and potentially put smaller hospitals out of business.
If hospitals like UPMC want to keep expanding and eating up market share, that’s fine, write Brownlee and Saini. Just don’t do it on the taxpayers’ dime. UPMC should either give up its non-profit status, or stop the expansion until there are measures in place to make real investments in community health.
If UPMC chooses the latter, they could “become a leader of that kind of investment, and serve as a model for hospitals nationwide,” write Brownlee and Saini.