Can a hospital that is ostensibly a “public charity” profit from and reinforce racism? It can, as demonstrated by the case of the University of Pittsburgh Medical Center. As the region’s largest employer, employing a fifth of the workforce working in hospitals alone, UPMC has a big hand to play in shaping the economic environment for the region. Nowhere is the devastation caused by low-wage service jobs like those provided by UPMC more prevalent than in Pittsburgh’s Black community.
The racism that is part and parcel of capitalism creates an ultra-oppressed sector of the working class who predominately rely on low-paying jobs to barely survive. Among 40 top regions, Pittsburgh has the highest rate of Black workers in low-wage service jobs at 34 percent. As a result, almost half of Black households in Pittsburgh earn less than $20,000 a year. One third of Black residents ages 18-64 live in poverty, giving Pittsburgh the third highest rate of poverty among working-age Black people of all major U.S. metropolitan areas behind only Milwaukee and Detroit. Some 45 percent of Black children under 18 and 53 percent of Black children under 5 years old are living in poverty. Average wages for Black men are 40 percent lower than the average white male full-time earnings in the region, making them the second lowest in the country behind only Cleveland. This oppression is even worse for Black women who on average earn about $2,000 less than Black men.
The results of low-wage employment and persistent, systemic unemployment are criminal. Home ownership rates are half that of whites, and half of Black workers report having no access to a private vehicle. Black infant mortality rates are 25 percent higher than national average and more than double that of whites, a greater disparity than in many other parts of the country. Death rates for diabetes are twice as high for Black people than the white population. Black Pittsburghers live almost six years less than white residents.
UPMC is a large part of the economic devastation of Black communities in the Pittsburgh region, but the community of Braddock faced UPMC’s racism firsthand with the closing of its hospital. Braddock is a low-income community just outside the city of Pittsburgh. Almost three-quarters of its residents are Black, and the median income for a family is just over $20,000. Braddock hospital, which was a full-service hospital that served more than 25 communities, opened in 1906; UPMC acquired it in 1996. In spite of massive community outrage and protest, UPMC closed it in 2010 claiming that it was underutilized. However, the occupancy rate was over 70 percent just before its closing, higher than other UPMC hospitals. Two years afterwards they constructed the new “UPMC East” hospital in Monroeville, a wealthier white suburb that already had a hospital, in a blatantly competitive move. UPMC left Braddock not only without a hospital, but without one of the last sources of jobs left in the neighborhood and a central communal space for Braddock residents.
UPMC also has the potential to damage communities of color even more across the entire country. As a government subcontractor, UPMC must legally comply with non-discrimination and affirmative action provisions. For nearly a decade now UPMC has been claiming that its hospitals, which provide services to federal employees, are not government subcontractors thus should not have to provide information about their hiring practices. However, in their latest appeal to the D.C. Circuit Court of Appeals they have actually gone so far as to say that the federal government does not have the authority to conduct audits to ensure compliance with non-discrimination laws that provide equal employment opportunities for women and people of color. This challenge has the potential to undo 50 years of established federal protections created to eliminate discrimination and ensure equal employment opportunities – not just for people in Pittsburgh but across the country.
As a health enterprise deemed a “purely public charity” that has expanded across the world to places like Cyprus, Ireland, Italy, and Kazakhstan, UPMC brings together many of the injustices of capitalism: health care for profit, tax-free regional exploitation, racist economic oppression, and capitalist imperialism. The people of Pittsburgh have had enough of bending over backwards for this health care giant. UPMC workers and communities of all nationalities are standing together to make this false non-profit pay for the enormous profits it extracts out of its grossly underpaid workforce and the taxpayers of the region.
The fight against UPMC is not just a local struggle for Pittsburgh but part of a fight taking place across the country and around the world against the racist inequalities and divisions that capitalism produces. There are many examples throughout history of the multinational working class fighting together to end racial injustices and winning. This struggle against UPMC will be another victory.
