NEW VIDEO: Summer Lee Takes on “Nonprofit” Hospital Monopolies Crushing Workers, Patients, Taxpayers 

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NEW VIDEO: Summer Lee Takes on “Nonprofit” Hospital Monopolies Crushing Workers, Patients, Taxpayers 

(Pittsburgh, PA – July 11th, 2023) – In a new video, More Perfect Union tells the story of how one hospital grew into a vast medical Empire by destroying its competition exploiting its workers and saddling patients with medical debt–and how how nonprofit hospitals across the country have transformed over the last few decades from one’s charitable institutions into engines of profit and all of it is powered by tax dollars. The investigation also details how Congresswoman Summer Lee’s experience growing up in a community devastated by UPMC’s closure of their only hospital has inspired her to take the giant on from her time as an organizer to the PA statehouse and now in Congress. 


  • UPMC Presbyterian was the first UPMC hospital founded in 1893. Like most hospitals at the time, it was largely focused on one thing, providing affordable medical care for anyone who needed it and consequently received tax exempt status.
  • In 1969, the tax code was modified so that a hospital didn’t have to pay taxes, as long as it was promoting health. Charity Care became optional. And nonprofit hospitals started looking a lot more like corporations. In the late 1970s and early 80s, boards began to think and feel more like a for profit enterprise with more MBAs and far fewer doctors and nurses to care for patients.
  • Fast forward to today and UPMC has grown from 12 to over 40 hospitals with its own insurance system in the past decade and employs more than 92,000 people, has an operating revenue of about 26 billion, and paid its former CEO $12.9 million and other top executives $225 million in 2021 alone–enough to keep hundreds of rural hospitals open or cancel the medical debt of hundreds of thousands of patients. 
  • At the same time, UPMC refuses to pay its own workers a livable wage, continues to raise costs on patients and cut corners on insurance coverage, and even directs their employees to apply for government assistance all while those same employees run their own food bank at work to help provide for themselves and their families. Survey results cited in the complaint UPMC workers recently filed with the DOJ found that 36% of UPMC hospital workers are in medical debt to their employer. Low-wage workers who responded reported being in debt to UPMC for medical care at an even higher rate coming in at 51%. In order to prevent workers from fighting back, UPMC has used its capture of the labor market to create a culture of fear and retaliation. While a third of AHN workers are unionized, UPMC has managed to remain almost entirely nonunion, sometimes by running afoul of federal labor law. The National Labor Relations Board ruled in 2018 that UPMC had illegally threatened pro-union workers and banned organizing materials in the workplace. 
  • As a tax exempt “nonprofit,” it’s technically supposed to provide affordable health care to the people who need it most, but UPMC’s same flagship hospital recently made headlines for being the least charitable nonprofit hospital in the country with a fair share deficit of $490 million for the whole system–enough to erase medical debt for 167,000 Pennsylvanians. Pittsburgh Mayor Ed Gainey recently launched a citywide review of tax-exempt properties in a Jan. 24 executive order, placing the nonprofit’s $1.7 billion in holdings up for review against the state’s standards for a “purely public charity.” 
  • In response, Congresswoman Summer Lee said, “The people of Western PA work hard for their paychecks. They pay their fair share in taxes–and hospital monopolies like UPMC should too. We already knew UPMC was ripping us off, exploiting our hospital workers to the point of a staffing crisis that puts our loved ones’ lives at risk, and leaving our most marginalized communities behind without access to care. But the fact that we now know that UPMC is cheating our community out of $246M on the backs of taxpayers, enough to erase medical debt for 167,000 Pennsylvanians – is shameful beyond reprieve. Instead of promoting the health of our families, they only care about promoting their profitability. It’s time for accountability.”
  • As UPMC has grown and increased profits, it shut down hospitals in poor, predominantly Black communities, leaving Braddock without its only hospital and its largest employer 2010 to pay for a larger hospital in wealthier, suburban Monroeville opened in 2012. Most recently UPMC closed its Intensive Care Unit at Mckeesport Hospital, another poor community.  
  • UPMC is able to get away with this in part because as the largest private employer in all Pennsylvania controlling ¾ hospital jobs in the commonwealth, it has a stranglehold on both the market for care and the job market. Recently acquiring its fourth hospital in Ireland as it cuts down on care in struggling communities in Pennsylvania, UPMC desires to be the Amazon of health care. 
  • UPMC is just one example of a much broader crisis. Three quarters of nonprofit hospitals are getting more in tax breaks than they’re spending on communities. That’s enough money to cancel the medical debt of 18 million Americans–raising big questions about who this health care system really serves and what it will take to reset the balance of power to care for workers and patients. 

The video features interviews with those on the frontlines of the fight to hold UPMC accountable including:

  • UPMC hospital worker and lead organizer Nila Payton, who has worked for the hospital system for over 17 years and has led workers’ organizing drive to unionize in recent years. After her son Roman was born in 2018, she was forced to go into over $1,000 of medical debt despite UPMC’s own policy showing that she should have received care for free given her income at the time.  She recently attended the State of The Union Address in DC as Congresswoman Lee’s guest.  
  • A nurse named Joel who discusses his struggles with staffing shortages and unlivable wages that are causing a crisis for hospital workers and patients in Western PA.

US Congresswoman Summer Lee has been organizing alongside and legislating on behalf of Nila and Hospital workers rising since her days in the Pennsylvania Statehouse, where she worked with hospital workers and patients to organize a takeover of UPMC’s board meeting and walkout that helped to push then-AG Shapiro to broker a historic deal to ensure millions of Highmark and UPMC patients did not lose access to care. She also founded the Pittsburgh Hospital Workers Taskforce along with State Rep. Sara Innamurato and held a hearing on Pittsburgh’s hospital workforce crisis [full video], roundtables with state and local electeds, and regularly joined workers at rallies. Weeks into her first term in Congress, Lee partnered with State Rep. Sara Innamorato and the American Economic Liberties Project on a report titled ​​Critical Condition: How UPMC’s Monopoly Power Harms Workers and Patients. “Like the steel corporations of the last century, UPMC has used its power to depress wages, degrade working conditions, extract money from the public, and, ultimately, create a crisis for the communities in which it operates and in which we live,” Lee and Innamorato said in the report’s introduction. In February, Lee invited Hospital Workers Rising Organizer Nila Payton as her State of the Union Guest, highlighting Nila’s struggle being in thousands of dollars of medical debt to her employer. Lee has begun to take federal action to hold UPMC Accountable–convening multiple roundtables to hear from workers on solutions they need to care for patients, leading a panel discussion on hospital monopolies at AELP’s recent Antimonopoly Summit where she spoke alongside FTC Chair Lina Khan, supporting the City of Pittsburgh’s investigation into nonprofit status. After workers filed a formal complaint with the DOJ on UPMC’s use of its market power to limit wages, increase workloads and keep workers from changing employers, Lee is now calling the DOJ to investigate the hospital monopoly’s abuse of wage penalties

In May, Congresswoman Summer Lee (PA-12) announced the introduction of her first bill, the Hazard Pay for Health Care Heroes Act, co-led by Reps. Ro Khanna (CA-17) and Barbara Lee (CA-12). Senator Ed Markey (D-MA) introduced the companion in the Senate. The bicameral legislation would empower the Secretary of the Department of Health and Human Services (HHS) to issue grants related to a hazard pay of up to $13 per hour / $25,000 per year and implement additional safety measures, such as Personal Protective Equipment (PPE) and alternative transit, for essential workers in health care and supporting services who are providing patients with immediate or undisrupted medical assistance during emergencies and extreme weather disasters. The legislation would be applicable to the full spectrum of workers in health care that make high quality health care possible, including home care workers, medical technologists, nurses, doctors, and environmental services staff.


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