A coalition of UPMC employees and activists hand delivered a letter to the Pittsburgh office of the Pennsylvania Attorney General on Monday morning, Tax Day.

The letter applauded Attorney General Josh Shapiro’s ongoing legal action against UPMC, which alleges the non-profit health care system is abusing its tax-exempt status. Those present said UPMC’s low wages and inadequate health insurance cause many workers to incur medical debt.

“Nobody wants to be in debt, let alone debt to their employer,” said breast cancer survivor Leslie Poston, an administrative assistant at UPMC Presbyterian. “I feel that [we need] better wages and better insurance. Because you might have UPMC insurance, your insurance is better than mine and I work for them.”

Poston said that her medical bills are so high that she can no longer go to the oncologist, which is frightening because that means she won’t know if the cancer returns.

“Please, I want to live. I’m not ready to go,” said Poston.

UPMC provides both health care and insurance, and is Pennsylvania’s largest private employer.

The legal issue with the attorney general concerns UPMC not accepting the health insurance from a competitor, which Shapiro said is a business strategy that hurts taxpayers.

Monday’s letter didn’t focus on the lawsuit, but rather the compensation of UPMC staff. But activists see the issues as related examples of the health care giant exploiting its non-profit status.

“Pennsylvania law requires that, to be a charity, a hospital has to relieve the government of some of its burden,” said the letter. “UPMC is creating a burden on the Commonwealth of Pennsylvania by creating a need for charity in its own workforce.”

In other words, the argument is that UPMC is complicit when its employees are saddled with medical debt, since it pays the salaries and provides the insurance, which workers use to pay UPMC for medical treatment.

“I grew up hearing about company stores,” said State Senator Lindsey Williams, referring to small communities where practically all the stores were owned by the area’s only major employer, such as a steel mill or coal mine. “This is a company store.”

The attorney general was not at the Pittsburgh office when the letter was delivered, though the office's spokesperson Joe Grace said, "We have received the letter and we’ll carefully review it."

UPMC declined to comment for this story.

WESA receives funding from UPMC.