Tuesday, December 1, 2009

Ascension Health and the Myth of Greater Charity Work at Religious Hospitals.

Ascension Health, one of the nation's top ten health care networks - and a Catholic institution - operates according to ERDs (ethical and religious directive). I popped over to their website to find out how they represented their services.

Don't miss this amazing glossary that lays out their definitions and practices on everything from abortion to brain death.

Then compare it to their "healthcare that leaves no one behind" page for some hard sell.

I was discussing my current book project with my sister on the phone yesterday. The book will, I hope, address the larger issue of patients' rights, but specifically end of life care in the US. I propose that the struggle over aid in dying is actually the struggle of three institution within society to assert their jurisdiction over suffering: the medical profession, the state, and the church. All three come together in the issue of religious hospitals.

My sister, in the midst of my pitch, stopped me and said, "But you seem to be forgetting the absolute good that the Catholic church does for the poor and needy." It's an argument that is often used to justify Catholic provider refusal of services. Because the Catholic health care entities care for the poor and uninsured, do so much charity, are so committed to the "least of these," and command the moral high-ground, they should be able to barter patients' rights for the sake of the good they do. Because many of the services Catholic organizations deny fall into the category of women's reproductive services - easily conflated with the single contentious issue of abortion - undue reverence has been given religious organizations and their restriction of services have been overlooked.

The argument goes: if you require Catholic institutions to deny their conscience and provide all services according to unrestricted patients' rights, they will leave the health care realm and the 20% of the population they serve will be left without.

This is a false argument. Statistically, Catholic hospitals and health care systems do no more charity than other non-profits. Yet the myth is that the Catholic church has a greater commitment to charitable work in health care. Even Ascension's page states, "In fact, in 2008 Ascension Health’s hospitals and other health facilities treated, on average, one uninsured patient approximately every 34 seconds, every day."

This care of the uninsured is not from the goodness of Ascension's heart. It is a due to a law in the US that all hospitals treat uninsured patients when they enter. That Ascension abides by federal law is not a unique good, it is a mandate, reimbursed by the federal government. And all hospitals in the country do the same. But Ascension continues to work the myth that Catholic hospitals do more good charity work than other health care organizations.

What has happened over the past three decades is that Catholic and other religious organizations, which began their hospitals and care facilities to address the needs of those in their denominations, were granted tax exemption and given the right to deny services according to their beliefs; they have moved farther and farther way from the charity of the church and into the business of health care, expanding their religious missions into the realm of personal rights. The government has allowed this, granting provider refusals for abortion after Roe v. Wade, and approving receipt of federal funds with the advent of Medicare and Medicaid. This creep of influence over patient's health care choice is profound and has been done with the approval of state and federal government for a number of reasons: most often because these institutions have sold themselves as committed to charity.

The Catholic Church has become good at running hospitals and health care facilities. And they have succeeded at imposing their ideology on more and more of the population. Now we face a point at which they are able to hold our health care freedoms hostage because they have grown so large.

How should federal and state governments address the either/or argument that my sister and so many others make that we must allow Catholic hospitals to impose on patients' rights or ask them to leave health care altogether? Compromise.

The work of The MergerWatch Project which advocates for patients' rights when a secular and Catholic hospital merge is an example of how communities rights can be protected in the face of Catholic ideology. By requiring and enforcing access to all health care services at the merged hospital, federal and state laws will ensure that patients are not denied necessary care. The Catholic facility can form a separate entity that provides these services, with separate finances. There are various other "creative solutions" that MergerWatch pursues.

What should not be allowed is reverence for any religious institution simply because it claims to do honorable charitable work. The government can not support any one religious ideology over another; they exist to protect individual rights.

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