Tuesday, January 5, 2010

Hospital Mergers Expand Catholic Mission of Discriminatory Care.

It's no secret that the Religious Right and the Catholic Right have struck a friendship over the past few decades over their shared desire to stem changes to women's roles in society. It's an alliance that would have been impossible in the 50s when Fundamentalists and Evangelicals considered Catholicism a cult. But the rise of feminism in the 60s and the decision of Roe v. Wade in the 70s brought them together.

As Frances Kissling, former president of Catholics for Choice writes in her article yesterday for Women's Media Center, pro-choice groups first were unsure of whether to work to protect Roe or to stand up to early efforts to restrict abortion access. They wrongly chose to work to protect the court decision. Hyde, she writes:

...first passed at a time that anti-abortion forces were pursuing two lines of attack against legal abortion—an effort to pass a human life amendment to the Constitution, which would make all abortions illegal, and an incremental strategy with the Hyde Amendment the first effort to chip away at Roe. The young prochoice movement realized that its naïve assumption that Roe would end the debate about abortion was wrong and that it needed to mobilize both grass roots and elite support for protecting abortion rights. The tactical question was whether the threat to poor women’s access in Hyde or the threat to all women’s access in the human life amendment would be the best organizing vehicle.

Based substantially on the advice of direct mail and political consultants, the decision was made to put efforts to overturn Hyde on the back burner and go against the less real threat of a constitutional amendment that would ban all abortions. The advice was clear and classist. It accepted the racism that lay buried in middle class hostility to poor women, “welfare queens” and the “sexually promiscuous”—all those who might be expected to look to Medicaid to pay for abortions—whom the rest of us should not support.

Not concentrating on overturning Hyde was arguably the worst decision the mainstream choice movement made. No effort at a constitutional amendment ever got off the ground, but the largely unchallenged Hyde Amendment emboldened anti-abortion groups to pick off powerless constituencies one at a time. From poor women they went on to adolescents and secured “parental consent and notification” laws.



The story of reproductive rights ever since then has been one of constant erosion of access, from parental notification laws, to waiting periods, to state laws regarding Medicaid coverage to a strong effort by the Catholic Church to expand their influence over health care via their hospital network. Today the Catholic Church operates 624 hospitals in the US and three of the top ten health care networks.

From Wendy Norris at RHRealityCheck today comes a story about the contested hospital merger in Colorado and the emboldened Catholic Church placing its health care system under greater pressure to adhere to the Ethical and Religious Directives which impose doctrinal care decisions on Catholic hospital patients.

The merger of publicly funded, tax exempt denominational hospitals - meant to serve entire communities, not just Catholic patients - with secular hospitals is a severely damaging trend for not only women's rights but patients' rights on the whole. If you read here often, you know that the 72 Ethical and Religious Directives not only discriminate against reproductive services but those delivered to gays, unmarried women and elders. When a Catholic hospital merges with a secular hospital, access to essential services for entire communities are eliminated.

For more links about the contested merger, see the bottom of the page.

Norris writes:

Backroom deals, multiple lawsuits and $600 million dollars mark the Sisters of Charity attempt to force religious medical directives on non-sectarian medical centers in Colorado.
A controversial move to transfer operational control of three secular Denver-area hospitals to a Catholic healthcare system expected to take place on December 31 appears to be on hold pending federal approval.
The unexpected delay by the Federal Trade Commission to bless the transaction may provide local critics with a last gasp effort to continue fighting the deal. Community members and medical professionals contend the transfer would unfairly subject comprehensive reproductive health and end-of-life care to church doctrine over patients' needs. The Catholic church considers abortion, contraception, elective sterilization and termination of invasive life support as "intrinsically evil" and refuses to provide these medical services or respect patients' advance directives.

The disputed takeover in Denver exemplifies the very serious implications for the 127 non-denominational hospitals that succumbed to merger fever with cash-flush Catholic health care systems in the 1990s. According to a study by Catholics for Choice, half of merged secular-Catholic hospitals suspended most or all of their reproductive health care services. Eighty-two percent denied emergency contraception to rape victims -- and more than a third refused to provide a referral.

But for some tax-exempt, nonprofit hospitals co-owned by secular and church interests, there was little more than a wink and a nod to church mandates on care. Comprehensive reproductive healthcare services quietly remained available.

These practices received higher scrutiny in 2001 when the U.S. Conference of Catholic Bishops revised its Ethical and Religious Directives for medical care to address "misinterpretation and misapplication of the principle of cooperation with other-than-Catholic organizations." In other words, the church would no longer turn a blind eye to reproductive health and end-of-life care at its secular partner facilities that did not meet strict Catholic orthodoxy.

MergerWatch.org notes several examples of broken promises by Catholic healthcare systems to preserve reproductive health services at non-religious hospitals it acquired through mergers. Typical reasons included newly installed diocesan bishops with more dogmatic views on medical directives or the Vatican overturning decisions made by previously autonomous bishops.

More importantly, the local hospital policymaking was a little noticed precursor to the bare knuckles strategy on recent display with the church's relentless lobbying for the 2009 Stupak and Nelson amendments to further restrict access to abortion care via publicly-subsidized health insurance plans. At the same time, the Catholic Archdiocese of Washington, D.C.,threatened to end social service programs for tens of thousands of poor residents if the city council approved a same-sex marriage ordinance.

Now, the Denver hospital takeover is offering a glimpse of the intense pressure being brought to bear by the church on its healthcare partners. The Vatican's renewed insistence on complete doctrinal influence on patient care is bolstered by very real threats to hold desperately needed institutional capital funds hostage until its theological demands are met.

And that once delicate balance between serving patient needs and adhering to strict Catholic medical directives is unraveling in plain sight.


Links:

From lifenews, a crystal clear demonstration of why the oddly allied Fundamentalist Right and Catholic Right support not only this merger but consider mergers a deft strategy in their work to restrict women's reproductive access. They're on a mission from God.

Denver Biz Journal.

Hospital Review.

State Bill Colorado.

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