By Neil Cosgrove
As June 30 approaches, the doomsday when the consent decree between the University of Pittsburgh Medical Center (UPMC) and Allegheny Health Network/Highmark expires, much justifiable sympathy is being directed towards those seniors enrolled in Highmark Medicare Advantage plans. From July 1, patients who have long used UPMC doctors and facilities will have to make upfront payments to continue such services, while Highmark attempts to cover exorbitant out-of network charges and reimburse those same patients. Also frustrating are UPMC’s vague, ambiguous reassurances that Highmark covered children will still have in-network access to Pittsburgh’s Children’s Hospital once the next key date of the consent decree arrives in June, 2022.
How can an alleged non-profit like UPMC behave, we wonder, in such a rapacious, competitive manner, especially after it is grown into a $19 billion behemoth that never experiences an operating deficit? “We built it with our patronage,” fumes Karen Kane of the Pittsburgh Post-Gazette, “as well as a tower of dollar bills amassed from cans at grocery store checkouts, philanthropic organizations, tax dollars uncollected, national grants in the billions and state capital credits.”
Amidst all the recent outrage and hand-wringing we must not forget how UPMC was also built by the hard labor of their service staff—the “medical techassistants,” janitors and housekeepers, cafeteria workers, research and administrative assistants— who for years has received poverty-level wages, inadequate benefits, and often arbitrary, punitive supervision.
UPMC has been consistent and steadfast in one way over those same years, in its opposition to those service workers forming a union. Since 2013, UPMC has been cited numerous times by the National Labor Relations Board (NLRB) for threatening, intimidating and surveilling workers lawfully engaged in union organizing in break rooms and on their own time.
Just this past August, Trib Live reports, the NLRB ordered UPMC to rehire three hospital workers it had illegally fired, “pay them for lost time, stop anti-union practices and inform employees of their rights to form a union.” Meanwhile, UPMC’s rival, Allegheny Health Network, recognizes hospital service workers organized by the Service Employees International Union (SEIU) and has quietly negotiated a three-year contract with those workers.
Why are UPMC’s service workers so desperately in need of a union? We can look to the common trinity of wages, benefits, and working conditions.
Wages: Late in 2015, a Wage Review Committee organized by City Council Member Ricky Burgess found that hospital service workers in Pittsburgh made an average of around $12.94 an hour. According to Jacobin Magazine, a 2014 Post-Gazette report found that UPMC “paid ordinary workers between 8 and 30 percent less than what they needed for basic expenses like rent and groceries.” In March, 2016 UPMC announced all of their workers would receive a minimum of $15 an hour by 2021, most likely worth less by then than the average $13 an hour they were getting in 2015.
In contrast, 10 UPMC executives received salaries of $2 million or more in 2016, with CEO Jeffrey Romoff earning over $8.5 million. Moreover, raises for service workers can come at a painfully slow pace. A patient care technician at UPMC Presbyterian for 11 years said she was lucky to get a 3% raise some years, “which is really nothing when your hourly wage is so low.” An administrative assistant in Presbyterian’s pathology department began in 2006 at $10.06 per hour and earned around $16 an hour 12 years later, mainly, Trib Live reports, “thanks to a one-time merit raise” after a change in job title.
Benefits: For UPMC workers, UPMC health insurance is their only option and, just like the old coal company stores, a possible road to long-term debt for some employees. “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, copays, deductibles and uncovered services,” Nicholas Theis, a research principal at UPMC Western Psychiatric, wrote recently. Employees, he added, can be left “with bills they can’t possibly pay with a single full-time job at UPMC.”
“We work in this system and provide health care,” Ellie Lalonde, also at Western Psychiatric, told Trib Live last fall, “and yet we can’t afford to access it for ourselves—not without bills that are so outrageous that we avoid seeking out health care.”
Working Conditions: Apart from the documented instances of harassment and punishment of workers seeking to unionize, understaffing has been another complaint of service workers in recent years. “When I started in 2005 it was a nice place to work. Floor was fully staffed,” recalls one patient care tech. But then chronic understaffing took its toll and this employee quit in December 2016. “You’re trying to do your vitals, call bells are ringing. You’re assisting a patient to the bathroom. Being understaffed all the time, patients are not getting the attention they need. They sense the stress that the staff is going through.”
Service workers are part of the community that enabled UPMC’s warp-speed growth over the years, and are fully deserving of the respect and consideration UPMC only reserves for its executives.
Neil Cosgrove is a member of the NewPeople editorial collective and the Merton Center board.
PHOTOS: (RIGHT) MATT IS GOING OUT ON STRIKE FOR BETTER HEALTHCARE. HOSPITAL WORKERS SHOULDN’T BE IN DEBT OR AVOID GOING TO THE DOCTOR. (lEFT) “I’M STRIKING BECAUSE UPMC EMPLOYEES SHOULD NOT BE IN MEDICAL DEBT TO OUR EMPLOYER, WHO IS ALSO THE INSURER!” – NILA PAYTON, UPMC PRESBYTERIAN