A coalition of labor teams on Thursday filed an antitrust complaint with the Justice Division in opposition to UPMC, the enormous Pittsburgh-based hospital employer, accusing the system of utilizing its monumental clout to depress wages and hurt staff.
In its grievance, 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 grievance 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 now watched UPMC develop and amass energy,” 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 essentially not unionized. After a sequence of acquisitions, it’s Pennsylvania’s largest personal employer with greater than 40 hospitals, 800 medical doctors’ places of work and clinics, and a well being plan. With working income of $26 billion final 12 months, it employs about 95,000 individuals.
Whereas antitrust circumstances ceaselessly tackle how highly effective organizations can function as monopolies and unfairly elevate costs, an organization will also be accused of working as a monopsony during which it exerts unfair leverage over suppliers, together with staff.
Well being care and authorized specialists say this can be a novel authorized strategy to think about the results on staff of widespread consolidation within the well being business.
Within the grievance, the unions declare that UPMC’s monopsony energy has additionally prevented staff “from exiting or bettering these working situations by way of a draconian system of mobility restrictions and widespread labor regulation violations that lock in sub-competitive pay and dealing situations.”
Reached for remark, a spokesman for UPMC didn’t instantly tackle the unions’ declare that it violated antitrust regulation, however defended its remedy of staff. The system “is among the many finest locations to work in all of the areas we served,” Paul Wooden, 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 not any different employers of dimension and scope within the areas UPMC serves that present good paying jobs at each stage and a median 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.
However federal regulators have signaled an elevated willingness to have a look at the results of an employer’s market energy on staff, and concern about how consolidation impacts labor markets “is gaining lots of momentum and a focus,” mentioned Jaime King, a regulation professor on the College of Auckland and an antitrust professional.
“The issue is way larger than a single merger in a single market,” mentioned Marka Peterson, authorized director for Strategic Organizing Middle, a labor coalition previously referred to as the Change to Win Federation.
The Justice Division may determine whether or not to undertake its personal investigation and whether or not any fees could be warranted.
The Biden administration highlighted its issues in regards to the influence of focus on labor markets in a 2021 executive order, and the Federal Commerce Fee just lately issued a proposed rule that will ban the usage of noncompete agreements.
Growing consolidation within the well being care business has additionally targeted some consideration on fallout among the many work pressure. Some analysis into hospital mergers has proven a discount in nurses’ wages. “Well being care stands out as being targeting either side,” mentioned Kate Bahn, an economist and analysis director on the City Institute.
And well being care staff, a lot of whom suffered extreme burnout through the pandemic, are in brief provide throughout the business. The excessive workloads led to quite a few strikes by nurses, together with recent 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 a number of the points raised within the grievance.
However whether or not the Justice Division will pursue motion in opposition to the well being system stays to be seen. Whereas federal regulators could seem sympathetic to the speculation underlying the unions’ grievance, these circumstances are difficult. “Monopsony circumstances will not be new, however they’re very exhausting to show,” mentioned Matthew L. Cantor, an antitrust lawyer and associate at Constantine Cannon.
This is able to 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 determine whether or not they have sturdy sufficient proof to take motion. “They’re not going to wish to struggle a case they don’t assume they will win,” mentioned Elena Prager, an economist on the Simon Enterprise Faculty on the College of Rochester who has served as a visiting scholar with the Justice Division.