Friday, January 08, 2010

By Tony Norman, Pittsburgh Post-Gazette

It's going to take more than a few months of bad press, candlelight vigils and zombies marching in front of its Downtown corporate headquarters to shame the University of Pittsburgh Medical Center into reversing its decision to close a much-needed hospital in Braddock.

At the end of the month, UPMC Braddock will close its doors, ending a 13-year "partnership" that began with a questionable merger and lots of skepticism about UPMC's intentions in a community fallen on hard times.

The Braddock Medical Center was already on the critical list when UPMC swooped in with bags of cash for operating room upgrades and other necessities.

Pittsburgh's most profitable nonprofit -- and largest employer -- had already merged with three other hospitals and purchased two more in the year leading up to its courtship of Braddock Medical Center.

Alarmed by the "whirlwind of health-care wheeling and dealing" with monopolistic intent generated by regional rivals UPMC and Allegheny General Hospital, a 1996 PG editorial asked:

"What happens when a needed hospital does not provide the perfect yin to either UPMC's or AGH's yang? What will happen to prices when capitalism yields, as is already happening, to a few huge monopolies? What will happen to the quality of treatment as all care becomes managed?"

The editorial ended on a cautionary note: "... we urge that whatever the imperatives of the market may be, quality and accessibility of care are always the paramount consideration."

Today, UPMC is an $8 billion nonprofit institution. Its operating revenue exceeds $2 billion. In the last year, it eliminated 500 full-time jobs in a bid to cut costs across the company. An estimated 2,701 doctors work for UPMC's network of regional hospitals.

Braddock residents and elected officials have appealed to UPMC's corporate overlords to reconsider the closing, citing the hospital's pivotal place in the community as its primary employer, medical caregiver and revenue generator.

For its part, UPMC insists that Braddock has to be closed because the beds are under-utilized. "Hospitals that lack the volume to keep the skills of its staff well-honed are not optimal environments," a vice president of public relations wrote to the PG in November.

As it turns out, UPMC Braddock's occupancy rate is only slightly below average for the region, so that explanation doesn't fly with the residents.

Even the 650 jobs that the residents of Braddock believe they are losing are merely being relocated into the larger UPMC network. "Qualified workers" will be able to do their old jobs somewhere else, we're being told.

None of these explanations, including vague promises to continue funding economic development in the area, carry any weight outside UPMC's corporate boardroom.

While the nonprofit is busy closing one of the most important institutions in the impoverished Mon Valley, it is also building a new hospital in relatively affluent (read: middle class) Monroeville nearby. Its rival West Penn Allegheny already has a modern hospital there. The "optics," as they say, are terrible.

In a counter-intuitive rhetorical flourish, UPMC maintains it is actually strengthening health care in Braddock by leaving, so that those in the area performing outpatient/physician care can thrive. It will come as a shock to those in Braddock that they will have more options and alternatives after the hospital closes.

The great Henny Youngman used to tell a joke that fits this situation perfectly:

Nurse: "Doctor, the man you just gave a clean bill of health to dropped dead right as he was leaving the office."

Doctor: "Turn him around. Make it look like he was walking in."

Next Friday, the advocacy group Save Our Community Hospital will mount another protest outside UPMC Braddock at 2:30 p.m.