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Der_Missionar OP t1_iy0a0p0 wrote

Reply to comment by AbsentEmpire in As Western Pa. hospitals expand, fears grow over higher health care costs, and Wolf's plan to address the situation by Der_Missionar

My friend is a doctor, and had his own practice, the problem he faced was that UPMC insurance wouldn't cover his practice, and essentially forced him into joining UPMC.

He was going under BECAUSE UPMC insurance wouldn't cover his practice. After it was clear he had no way of staying in business UPMC "graciously" offered to buy him out.

Several friends in this situation.

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pa_bourbon t1_iy0s2av wrote

There is one additional complexity. PA has not passed tort reform for medical malpractice. As a result, awards are basically unlimited and up to jury discretion.

That makes malpractice insurance for private practices VERY expensive. Large conglomerates like UPMC and AHN pool the risk and may even self insure to some degree.

Local doctors just can’t afford it. I have a buddy that was a urologist. He was paying over 750K a year for malpractice insurance in PA for a 5 doctor private practice group almost 10 years ago. He moved to a midwestern state that had reasonable tort reform in place and paid $400K for a 7 doctor private practice in the same field.

Those malpractice insurance costs are driving a lot of doctors to sell.

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AbsentEmpire t1_iya320b wrote

Why would UPMC insurance cover practices they don't own?

It's a smart business move by them to consolidate the market to themselves if they want to be around and offering advanced procedures in another decade.

This is the inevitable outcome of having health policy that pretends that a free market can exist in the health care industry.

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Der_Missionar OP t1_iya9asx wrote

It's actually VERY NEW to have an insurance company OWN the hospitals and the doctors offices. Up until a few years ago, this never happened.
Insurance was insurance, hospitals and doctors were hospitals and doctors. Now it's all intermingled. So... That's an ongoing discussion in the government. Don't you remember the BIG TODO with UPMC refusing to cover anything in Allegheny Health Network?

This is the stuff of anti-trust lawsuits going on right now.

So, yeah, insurance never owned the doctors offices and hospitals before.

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