“UPMC’s monopoly powers have gone too damn far,” Representative Summer Lee said during a press event earlier this year.
Lee, a Democrat, represents Pennsylvania’s 12th congressional district, an area in and around Pittsburgh. She was calling out the University of Pittsburgh Medical Center, a large hospital system that has been locked in a labor battle with the SEIU, as well as fights with a series of public officials, for the last several years. UPMC epitomizes the transition of Western Pennsylvania from a region built on heavy industry and manufacturing, dating back to days of U.S. Steel, to one built on “eds and meds,” as the saying goes, referring to the major universities and hospital systems that dot the region and are now its major employers.
But in some ways, nothing has changed at all, with the region trading one set of dominant firms for another. It’s still a company town, just run by a different company. UPMC’s vast power, acquisitions spree across not just Pennsylvania but the world, and routine battles with labor have earned it the ire of Lee, members of the Pennsylvania statehouse, and Pittsburgh Mayor Ed Gainey, whose administration is investigating nonprofit tax abuse across the city, putting UPMC squarely in its sights.
There’s more to this fight, though, than a localized political battle. Philadelphia usually earns the lion’s share of the Keystone State’s national media and political pundit attention—the recent Philly mayoral primary was treated as a proxy battle for the left’s various factions, for example, with progressive favorite Helen Gym’s uninspiring finish treated as proof positive that that wing has overreached. But Pittsburgh and its environs are actually worth paying attention to if you want to understand a viable path for Democrats to build the sort of coalitions they need not just to maintain what they currently have, but to build toward a model that can persuade more than the traditional liberal base. The strategy Democrats employed there, which focuses on centering corporate power while not forgoing what makes Democrats, well, Democrats, has allowed them to challenge political machines, best incumbents and Beltway darlings alike, build new models for local political organizing, and maybe, just maybe, set a standard for other Democrats across the country.
Pennsylvania, of course, has a reputation as a new, swingy swing state, having gone to former President Donald Trump in 2016, before flipping back to President Joe Biden in 2020. Democrats more than held serve in 2022, with Senator John Fetterman, himself a product of Allegheny County politics, flipping the U.S. Senate seat previously held by Republican Pat Toomey, then–Attorney General Josh Shapiro ably fending off MAGA hero Doug Mastriano to win the governor’s mansion, and the party winning control of the state House of Representatives (after a convoluted election season straight out of The West Wing, during which a deceased candidate won and an interim “compromise” speaker was required).
Lee also won her seat in 2022, four years after ousting a Democratic statehouse incumbent, as did U.S. Representative Chris DeLuzio, who holds the seat in a neighboring district previously held by centrist idol Conor Lamb. DeLuzio ran campaign ads explicitly calling out “corporate jagoffs” for price-gouging, outsourcing jobs, and raising prices, leaning into a narrative about the corporate role in rising inflation that economists and mainstream journalists alike poo-pooed—until they suddenly didn’t.
In Congress, DeLuzio has continued to focus on corporate greed. Following the East Palestine, Ohio, train derailment, which occurred just a mile away from his district, for example, he introduced multiple pieces of railroad safety legislation. “For far too long, the railroads have put their profits ahead of safety and communities like Western Pennsylvania,” he said. “I will keep fighting for every one of my constituents who Norfolk Southern has hurt through their greed and incompetence.”
Synergy between different levels of government is a key aspect of this emerging model, so it wasn’t surprising to see Pennsylvania House Democrats pushing the same goals. State Representative Rob Matzie, another Western Pennsylvania legislator, ushered through a bill establishing new requirements for railroads operating in the state. Another statehouse member from the area, Representative Nick Pisciottano, has also made challenging corporate power a legislative centerpiece. He’s introduced groundbreaking price-fixing legislation, co-sponsored a major antitrust reform bill, and is shepherding a bill through taking on so-called “junk fees,” the ubiquitous charges that corporations from Ticketmaster to rental car companies to hotels throw on your bills simply because they can. This is an issue so potentially electorally potent that it merited a mention from Biden in the State of the Union, and Pisciottano’s bill is the most comprehensive of a suite of similar legislation across the country.
Continuing this virtuous political-policy cycle, DeLuzio has criticized Ticketmaster’s power, calling to break the ticket-seller away from LiveNation, which gives it a monopoly over the live events industry. He and Lee have also been campaigning against noncompete agreements, the tool that employers use to lock workers into their job and which have become so economically problematic that the Federal Trade Commission and multiple state legislatures moved this year to eliminate them almost entirely.
In the same vein, Representative Sara Innamorato—another Western Pennsylvania official who recently won the Democratic nomination to be Allegheny County Executive—is working to rein in so-called TRAPS, abusive employee debt agreements which force workers to repay often hefty training costs before leaving for a new job. Her legislative work has also focused on reining in corporate power, whether through repealing tax subsidies, reforming antitrust and merger law, or ensuring people can access the resources fix their own homes, instead of selling them off to developers. That theme carried through to her county-level race, where she proved a whole lot of naysayers wrong and shook off a late barrage of attack ads to win, convincingly.
What these perhaps disparate policy fights all have in common is they are connected to the real economy that people see and feel in the jobs they work, the bills they pay, the stores they shop in, the events they want to attend. Focusing on such tangible matters builds trust and appeals across the political spectrum on issues where Democrats tend to trail Republicans, generally (if unfairly): Who is more focused on the economy, who is more likely to create jobs, and who will do the most to bolster local businesses.
They also unite parts of the left—including labor, environmentalists, and consumer advocates—while still appealing to constituencies more traditionally associated with conservative politics, like white, working-class voters and small business owners. And they allow progressives to offer a real policy counterproposal to the faux-anti-corporate populism of the right, pushed by the likes of Donald Trump and Ron DeSantis, which mostly involves yelling “woke” and “Big Tech” while shoveling ever more tax breaks and regulatory favors at dominant corporations.
Perhaps no fight exemplifies this tactic better than that against UPMC. The list of those harmed by UPMC’s monopoly power is extensive: Workers who are locked into working there through debt or restrictive contracts, independent pharmacists who were dropped from its network, patients who have seen staffing ratios plummet, and small businesses and families whose care was tied up in a longstanding insurance feud between UPMC and the region’s other major hospital.
Last year, Lee and Innamorato organized a working group of state and local officials concerned about UPMC’s effect on the local labor market and hosted a hearing at which workers and employment experts aired their problems with how UPMC is allowed to operate. They also released a policy agenda for addressing its power (which, full disclosure, my organization, the American Economic Liberties Project, worked on). Some pieces of that agenda, such as Pittsburgh’s tax investigation, are already advancing.
Marrying local worker solidarity, an unchecked corporate villain, strong local organizing, and an affirmative policy agenda for dealing with it may not sound revelatory, but in a world of endless political noise, super-short news cycles, and an election season that never seems to come to a close, it’s working in Western Pennsylvania—and that might just be good enough for everywhere else too.
