A coalition of labor teams on Thursday filed an antitrust criticism with the Justice Department in opposition to UPMC, the enormous Pittsburgh-based hospital employer, accusing the system of utilizing its huge clout to depress wages and hurt staff.
In its criticism, the group, which incorporates SEIU Healthcare Pennsylvania, claims UPMC staff are topic to a “wage penalty” as a result of of 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 workers to enhance working circumstances.
“We have watched UPMC develop and amass energy,” mentioned Matthew Yarnell, the president of the SEIU group there, which has lengthy sought to prepare 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 docs’ places of work and clinics, and a well being plan. With working income of $26 billion final yr, it employs about 95,000 folks.
While antitrust circumstances regularly 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 during which it exerts unfair leverage over suppliers, together with workers.
Health care and authorized consultants say it is a novel authorized method to contemplate the consequences on staff of widespread consolidation within the well being trade.
In the criticism, the unions declare that UPMC’s monopsony energy has additionally prevented staff “from exiting or enhancing these working circumstances by way of a draconian system of mobility restrictions and widespread labor regulation violations that lock in sub-competitive pay and dealing circumstances.”
Reached for remark, a spokesperson for UPMC didn’t immediately deal with the unions’ declare that it violated antitrust regulation, however defended its remedy of workers. The system “is among the many greatest locations to work in all of the areas we serve,” 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 not any different employers of measurement and scope within the areas UPMC serves that present good paying jobs at each degree and a mean wage of this magnitude,” he added.
He additionally mentioned that the well being system assigned nurses based mostly on affected person want and that there was no coverage that may 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 loads of momentum and a spotlight,” mentioned Jaime King, a regulation professor on the University of Auckland and an antitrust professional.
“The downside is far larger than a single merger in a single market,” mentioned Marka Peterson, authorized director for Strategic Organizing Center, a labor coalition previously often called the Change to Win Federation.
The Justice Department might determine whether or not to undertake its personal investigation and whether or not any expenses could be warranted.
The Biden administration highlighted its issues in regards to the influence of focus on labor markets in a 2021 government order, and the Federal Trade Commission not too long ago issued a proposed rule that may ban the use of noncompete agreements.
Increasing consolidation within the well being care trade has additionally centered some consideration on fallout among the many work drive. Some analysis into hospital mergers has proven a discount in nurses’ wages. “Health care stands out as being targeting each side,” mentioned Kate Bahn, an economist and analysis director on the Urban Institute.
And well being care staff, many of whom suffered extreme burnout through the pandemic, are briefly provide throughout the trade. 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 yr echoed some of the problems raised within the criticism.
But whether or not the Justice Department will pursue motion in opposition to the well being system stays to be seen. While federal regulators might seem sympathetic to the speculation underlying the unions’ criticism, these circumstances are difficult. “Monopsony circumstances aren’t new, however they’re very onerous to show,” mentioned Matthew L. Cantor, an antitrust lawyer and associate 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 determine whether or not they have robust sufficient proof to take motion. “They’re not going to wish to battle a case they do not assume they will 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.