Pittsburgh City Council voted Tuesday to approve a University of Pittsburgh Medical Center (UPMC) plan to build a vision and rehabilitation center in the city’s Uptown neighborhood, part of a $2 billion expansion the hospital giant announced last year. The vote came despite continued opposition from Pittsburgh residents, who say UPMC has repeatedly denied its workers the right to unionize and is exacerbating racial health disparities.

For weeks, Pittsburgh residents have demanded that UPMC negotiate a community benefits agreement guaranteeing all Pittsburgh residents equal access to health care, the right to unionization for UPMC workers, and a $15 minimum wage.

Before the vote, Councilmember R. Daniel Lavelle (D) announced that UPMC had agreed to a list of nonbinding conditions, including developing an addiction specialty clinic, support for affordable housing and education in the community, and making efforts to recruit and hire people of color.

This is the unsigned set of bullet points that UPMC and Pittsburgh City Council are calling a Community Benefits Agreement. pic.twitter.com/V2NEli5iLb — Moshe Marvit (@MosheMarvit) July 31, 2018

But activists and councilmembers who opposed the expansion said the list was insufficient.

“This is all great and they should be doing this anyhow,” Councilmember Darlene Harris (D) said at the hearing Tuesday, adding that what’s missing from the agreement are promises to “stop harassing people and hiring people to stop unions from starting” and commitments to treat all patients regardless of where they live or what insurance card they carry.

Harris’ comments were met with cheers and applause from Pittsburgh residents who packed the council meeting ahead of the vote. Dozens took turns speaking, slamming the health care giant for its poor treatment of workers and for neglecting to including community members in the negotiations.


“We found out about [the list of conditions] last night and it’s being voted on today,” Summer Lee, a Democratic socialist candidate for Pennsylvania state House, told ThinkProgress prior to the vote. “We need development, but development that doesn’t take into account the community’s needs is not development that we need.”

“If you bow down to a bully, they will keep pushing forward”

UPMC is the Pittsburgh area’s largest single employer and Pennsylvania’s largest non-governmental employer, with about 80,000 employees spanning more than 30 hospitals and 600 doctors’ offices and outpatient clinics. Over the past several years, UPMC has spread its tentacles across the region, buying and expanding upon dozens of local hospitals. In the process, it has also shrunk the local insurance market, turning it into a virtual monopoly.

“In terms of their footprint here and how many people they employ, it’s a lot,” said Moshe Marvit, a Pittsburgh-based fellow at The Century Foundation. “The doctors seem to do okay, but as you go down the employment ladder, it’s lower wages, longer hours … If you lose your job at UPMC, you’re sort of blackballed. You could go to Allegheny General. But other than that, there’s not a lot of places you could go.”

Allegheny General Hospital is part of Highmark’s Allegheny Health Network, Pittsburgh’s other health care giant, which shares the limited insurance market with UPMC and has also planned massive expansions of its own. UPMC and Highmark insurance members will be completely and officially separated from the other’s provider network in 2019. Already, many Pittsburgh residents have lost access to their doctors as a result of the increasingly limited choices in the insurance market.


“You don’t do it [expansion] at the expense of peoples’ lives. And this is a situation of life and death,” Brandi Fisher, economic justice organizer at Pittsburgh UNITED, told ThinkProgress. “Someone living in the Hill District needing to go to a hospital that’s two minutes away not going there because they have Highmark insurance? That’s ridiculous.”

UPMC needs to think about us. And we’re sick and tired of being sick and tired. – UPMC Mercy hospital worker pic.twitter.com/ZStpdtkiH4 — HospitalWrkersRising (@PGHHospitalWork) July 31, 2018

Although UPMC is a tax-exempt non-profit, they operate like a for-profit organization, Marvit said.

“They’re a non-profit, they don’t pay taxes on the land they own and they own a lot of land. So there’s this lingering question of what they owe back to the community because they don’t pay taxes,” he said.

A 2013 lawsuit against UPMC sought to remove the hospital’s tax-exempt status, but Pittsburgh Mayor Bill Peduto (D) ultimately decided to drop the suit, vowing to hold the hospital accountable through more diplomatic means.


Since then, however, activists say Peduto has done little to keep UPMC in check, likening his support of the health care chain to his efforts to court Amazon in building its second headquarters in the city. Last week, in a statement, Peduto announced his support for UPMC’s proposed vision and rehab center, lauding the “transformative effect it will have on Uptown and the HIll District.”

“In his bid to get Amazon, what won’t he agree to?” Lee told ThinkProgress, referring to efforts to silence and contain protesters in an effort to attract the company to the city. UPMC, she said, has influenced the mayor in the same way.

“I don’t know what UPMC’s plans are moving forward, but I know that if you bow down to a bully, they will keep pushing forward,” she added. “To have that sort of control over our governing body is frightening… What would ever curtail UPMC’s behavior? Nothing.”

LIVE: Our city still needs UPMC to provide ALL patients w/ access, to do MORE to fulfill its community health needs assessment & to RESPECT worker rights. We need to lift up voices of the community & ensure the community is a decision maker in the development that affects us all! pic.twitter.com/Gi9oyx9j5G — Pittsburgh UNITED (@PghUNITED) July 31, 2018

Through it all, UPMC has treated its workers poorly and created rifts in health care access across the city. Employees have been pushing for a $15 minimum wage as early as 2014 and although the hospital recently agreed to raise the minimum wage in 2021, workers say that’s not soon enough.

The fight for unionization has lasted longer, since 2012. While some UPMC branches have nurses unions (remnants of small hospitals that UPMC purchased), the hospital has been denying its workers the right to unionize for years. In 2014, the National Labor Relations Board (NLRB) ruled that the chain was discriminating against workers who tried to organize a union, violating the law in the process.

“Employees were surveilled and photographed, interrogated and threatened with discipline and arrest. Four were fired,” Marvit wrote in a 2014 piece for In These Times. “The decision also found that UPMC helped create and support a ‘company union’ — an employer-dominated labor organization — in violation of federal law.”

UPMC’s anti-union campaign also stretched to its internal company website, where it posted notices intended to dissuade employees from organizing, including a post encouraging workers to seek advice from National Right to Work, and another titled “Why SEIU Isn’t Necessary.”

UPMC's intranet contained numerous postings to dissuade workers from unionizing. (Credit: Courtesy of Moshe Marvit)

In the community, UPMC’s actions have hurt vulnerable residents. Lee said the health care chain’s 2010 decision to shut down its hospital in Pittsburgh’s Braddock neighborhood left the largely poor and black population without health care. Not much has changed since then, she said, adding that the hospital continues to worry most “about UPMC’s bottom line and their profits.”

“The hospital was something that was integral to our community … we basically begged UPMC to not pull out,” she added. “Our most vulnerable, our seniors, have to travel very far to get medical care.”

LIVE: @SummerForPA asks Council to stand on the side of people. Learn from Braddock, listen to the people, and reject UPMC’s plan. pic.twitter.com/XYW5MPu7mR — Pittsburgh UNITED (@PghUNITED) July 31, 2018

Numerous activists echoed Lee’s words during the hearing, citing the city’s pressing health problems, including infant mortality and opioid addiction, as evidence that UPMC has not done enough to give back to the community.

“The people aren’t going to be deterred,” Lee said. “What the people are asking for is not something major, it’s not radical, it’s basic human dignity.”