Competition: for better or worse? Highmark, UPMC square off over planned merger of AUH-West and West Penn.(Highmark Blue Cross Blue Shield; UPMC Health Systems; Allegheny University Hospitals-West; Western Pennsylvania Hospital)

DOWNTOWN - In his office on the 30th floor of Fifth Avenue Place, James Klingensmith laid out 11 pages of color-coded charts to make his case that Highmark Blue Cross Blue Shield should help finance the merger of Western Pennsylvania Hospital and Allegheny University Hospitals-West with a $125 million loan.

"It all comes down to the question: What kind of health care system do you want for your family in the future" - one with viable alternatives or not, said the Highmark group executive vice president.

Officials at Highmark's arch rival, UPMC Health System, vehemently object to the insurer's involvement in the deal, saying it is really an attempt by Highmark to get into the hospital business.

Employers and consumers alike should closely watch the heated debate over Highmark's role in the proposed merger of AUH-West and West Penn, expected to close by the end of May.

At issue is whether competition among local health systems is a good or bad thing for employers and consumers who pay health care premiums.

It is a question that academics continue to debate and the answer here remains to be seen. But Highmark and UPMC have gone to the mat over the issue - with each predicting dire results should their wishes not prevail.

"What we …