In the summer of 2015, I returned to Pittsburgh to begin a postdoctoral fellowship on the politics of health care, the industry for which the region—following the long decline of steelmaking—had become increasingly well known. Not far from my office, a short walk from the hospital where my mother once worked as a cardiac-unit nurse, that industry's contradictions had begun to flare up.

As I would soon discover, a war had been raging between the region's largest health system, the University of Pittsburgh Medical Center (UPMC), and its largest insurer, Highmark. Several years prior, UPMC had announced it would end its contract with Highmark following Highmark's decision to acquire a hospital system of its own. Now a tenuous consent decree brokered by the state held access to care for thousands of people in the balance. Following some coverage critical of UPMC in the Pittsburgh Post-Gazette, UPMC banned the sale...

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