A coalition of labor teams on Thursday filed an antitrust criticism with the Justice Department towards UPMC, the large Pittsburgh-based hospital employer, accusing the system of utilizing its monumental clout to depress wages and hurt staff.
In its criticism, the group, which incorporates S.E.I.U. Healthcare Pennsylvania, claims UPMC staff are topic to a “wage penalty” due to the well being system’s dominance in native markets. The criticism describes nurses who’re given heavier workloads than nurses at different hospitals, creating issues over affected person security, and catalogs what the coalition considers to be labor regulation violations that it says illustrate the powerlessness of staff to enhance working situations.
“We have watched UPMC grow and amass power,” mentioned Matthew Yarnell, the president of the S.E.I.U. group there, which has lengthy sought to arrange staff on the well being system, which is basically not unionized. After a collection of acquisitions, it’s Pennsylvania’s largest non-public employer with greater than 40 hospitals, 800 medical doctors’ workplaces and clinics, and a well being plan. With working income of $26 billion final 12 months, it employs about 95,000 folks.
While antitrust circumstances incessantly deal with how highly effective organizations can function as monopolies and unfairly elevate costs, an organization may also be accused of working as a monopsony through which it exerts unfair leverage over suppliers, together with staff.
Health care and authorized consultants say this can be a novel authorized strategy to think about the consequences on staff of widespread consolidation within the well being business.
In the criticism, the unions declare that UPMC’s monopsony energy has additionally prevented staff “from exiting or improving these working conditions through a draconian system of mobility restrictions and widespread labor law violations that lock in sub-competitive pay and working conditions.”
Reached for remark, a spokesman for UPMC didn’t instantly deal with the unions’ declare that it violated antitrust regulation, however defended its therapy of staff. The system “is among the best places to work in all the regions we served,” Paul Wood, UPMC’s chief communications officer, mentioned in an e mail. He mentioned the system’s common wage was greater than $78,000 yearly.
“There are no other employers of size and scope in the regions UPMC serves that provide good paying jobs at every level and an average wage of this magnitude,” he added.
He additionally mentioned that the well being system assigned nurses primarily based on affected person want and that there was no coverage that will prohibit an worker who left one facility from being rehired at one other one.
But federal regulators have signaled an elevated willingness to take a look at the consequences of an employer’s market energy on staff, and concern about how consolidation impacts labor markets “is gaining a lot of momentum and attention,” mentioned Jaime King, a regulation professor on the University of Auckland and an antitrust professional.
“The problem is much bigger than a single merger in a single market,” mentioned Marka Peterson, authorized director for Strategic Organizing Center, a labor coalition previously referred to as the Change to Win Federation.
The Justice Department might resolve whether or not to undertake its personal investigation and whether or not any prices could be warranted.
The Biden administration highlighted its issues in regards to the influence of focus on labor markets in a 2021 govt order, and the Federal Trade Commission not too long ago issued a proposed rule that will ban using noncompete agreements.
Increasing consolidation within the well being care business has additionally centered some consideration on fallout among the many work pressure. Some analysis into hospital mergers has proven a discount in nurses’ wages. “Health care stands out as being concentrated on both sides,” mentioned Kate Bahn, an economist and analysis director on the Urban Institute.
And well being care staff, a lot of whom suffered extreme burnout throughout the pandemic, are briefly provide throughout the business. The excessive workloads led to quite a few strikes by nurses, together with latest walkouts at New York City hospitals.
UPMC has typically been criticized for what some describe as anticompetitive conduct, and a report launched earlier this 12 months echoed among the points raised within the criticism.
But whether or not the Justice Department will pursue motion towards the well being system stays to be seen. While federal regulators might seem sympathetic to the idea underlying the unions’ criticism, these circumstances are difficult. “Monopsony cases are not new, but they are very hard to prove,” mentioned Matthew L. Cantor, an antitrust lawyer and companion at Constantine Cannon.
This could be the primary case to rely totally on the argument {that a} highly effective well being care employer is utilizing its clout in ways in which hurt staff, and prosecutors should resolve whether or not they have robust sufficient proof to take motion. “They’re not going to want to fight a case they don’t think they can win,” mentioned Elena Prager, an economist on the Simon Business School on the University of Rochester who has served as a visiting scholar with the Justice Department.