Tag Archives: Catholic health care

Is Catholic health care a thing of the past?

Matthew Rarey: consolidation, regulation, and persecution pose a three-fold challenge . . . 

Health care providers are taking a beating from ObamaCare, and Catholic hospitals and physicians fighting to keep the faith are no exception. Many suspect that the end game is not only a singlepayer system, but a shutdown of faith-based delivery.

“Catholics should be worried,” warns John M. Haas, president of the National Catholic Bioethics Center. “It’s not so much a Catholic identity issue within Catholic health care, but fierce and relentless threats from government and a profound shift in cultural attitudes regarding issues such as contraception.”

Such threats have already forced the Church out of other social ministries — including adoption services — thanks to laws and mores condoning same-sex “marriage.”

Regulatory culture

A statue of the Blessed Mother stands in front of Loretto Hospital in New Ulm, Minn.

A statue of the Blessed Mother stands in front of Loretto Hospital in New Ulm, Minn.

John F. Brehany is executive director and ethicist of the Catholic Medical Association, an association of individuals across the country dedicated to learning, implementing, and sharing their faith in the health care industry. Most of its 2,000 members are physicians.

He cites two factors militating against a robust Catholic identity in health care.

“First, the federal government is actively hostile to the Catholic faith and at best indifferent to the protection of conscience rights in organized medicine,” Brehany says. Of particular concern is the Health and Human Services (HHS) mandate. This employer requirement to provide insurance plans covering contraceptives, abortifacients, and sterilization procedures is “proving a real challenge to the Catholic institutional presence in health care.”

The U.S. Supreme Court heard cases seeking the mandate’s repeal in late March and is expected to give its ruling at the end of June.

Second, says Brehany, is the financial pressure being exerted upon health care providers to stay in business. To “cut more costs out of the delivery structure, many are consolidating,” he notes. Encouraging this trend is the need to comply with ever more burdensome federal regulations — a costly procedure that’s putting many physicians out of private practice.

“Government has so ramped up regulations and penalties for compliance with federal law that private physicians are being driven out of business and joining hospitals,” Brehany explains. “They can’t afford the software systems and lawyers necessary to letting them know whether they’re in continual compliance,” thus avoiding crippling penalties. When Catholic hospitals consolidate with non-Catholic hospitals for similar reasons, these consolidations can pose “a challenge to maintaining a robust Catholic identity.”

Consolidation, not compromise

John Haas

John Haas

In 2012, Catholic Healthcare West relinquished its formal Catholic identity in order to expand its network to include non-Catholic hospitals, thus increasing its marketing power and profitability. Now called Dignity Health, it may be a harbinger of further consolidations by which Catholic health care providers drop their Catholic identity for the sake of the bottom line.Despite that change in name and formal identity, “there’s more than meets the eye with the Catholic Healthcare West issue,” Haas notes. Dignity Health’s transformation was made in consultation with the Church and approved by former San Francisco Archbishop George Niederauer. It has promised to run its Catholic hospitals in accord with the U.S. Conference of Catholic Bishops (USCCB) document Ethical and Religious Directives for Catholic Health Care Services.

“But it now means that the overarching system of Dignity can bring non-Catholic hospitals into the system and have them continue doing things Catholic hospitals can’t,” says Haas, citing sterilization procedures. “Dignity has said none of its hospitals can perform abortions, however. There’s still a strong Catholic moral influence.”

Haas says that consolidation is the trend of the future.

“You can find almost no freestanding hospitals anymore — they’re all entering into collaborative arrangements to survive,” he told Legatus magazine shortly after returning from a meeting in Rome, where he is a member of the Pontifical Academy for Life. “When a non-Catholic hospital or system puts pressure on a Catholic partner to do things not in accord with moral law, that’s where the threats come in.”

The National Catholic Bioethics Center, led by Haas, gives ethical guidance to Catholic health care providers considering collaborative arrangements with non-Catholic entities, helping them stay true to their Catholic identity. A major concern is maintaining the principle of non-material cooperation with evil.

The NCBC worked with one Catholic health care system for over a year to maintain its integrity through the consolidation process, Haas says. The $620 million deal did not happen until the NCBC affirmed that no ethical or religious directives would be broken.

“What came into play were tubal ligations, contraception, and sterilization, which are such a miniscule part of the overall delivery of health care but in our day and age, such a neuralgic issue,” says Haas.

Peter Breen

Peter Breen

For now, vigilant bishops are key to ensuring the Catholic identity of Catholic health care, Haas says. However, a game changer may be in the works: The Obama administration’s repeal of conscience provisions, which had allowed health care providers to receive federal funds despite refusing to perform procedures the Church deems unethical, could threaten the very existence of Catholic health care.

“You often hear people saying with great bravado that a Catholic hospital would close down before it did abortions [to receive the government funding so vital to their operation],” he notes. “If it came to that and a Catholic hospital refused to do abortions, the state could take it over and say this institution exists by our leave as a non-profit. It’s happened before in Church history, but not yet here in America.”

Catholic health care in the catacombs?

Peter Breen, executive director and legal counsel of the Thomas More Society, says the movement in politics to devalue faith-based ministries has turned into active hostility.

Concerning mergers between Catholic and secular health care institutions, Breen says “there’s a real fight over whose ethics will win out.” In a case not yet made public, the Thomas More Society is defending a Catholic doctor that a secular hospital involved in a partnership with a Catholic hospital refused to hire because of his opposition to administering abortifacient birth control.

Even more ominous, Breen cites a recent suit that the American Civil Liberties Union filed against the USCCB because its Ethical and Religious Directives bars abortion.

“I don’t mean to be apocalyptic,” says Breen, “but if Catholic bishops are unable to set ethical guidelines for institutions calling themselves Catholic, we’re going to have a hard time maintaining an official relation between the Church and not-for-profit Catholic health facilities. If the ACLU is successful, we’ll be put in a tough spot as a Church.”

Joseph Piccione, senior vice president for mission and ethics at Peoria, Ill.-based OSF HealthCare System, says he’s hopeful yet realistic about the continuance of that fundamental part of Catholic discipleship and identity: caring for the sick.

“When we see how Catholic ministries have struggled to remain active even in oppressive communist regimes, we know that we have a learned flexibility from their example,” says Piccione, who holds a licentiate in theology as well as a civil law degree. “We need to be quick on our feet and find ways to continue to serve. Why? Because that’s what the Lord wants of us.”

MATTHEW A. RAREY is Legatus magazine’s editorial assistant.

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The truth about Catholic health care

Health care was essential to Jesus Christ, it’s essential to the Catholic Church . . .

Dr. Patrick Lee

While there are no Catholic restaurants or Catholic grocery stores, there are specifically Catholic hospitals, clinics, hospices and nursing homes. Why? Catholic health stems from how Jesus conducted his public ministry. He not only preached and forgave sins, but he cured, restoring sight to the blind, hearing to the deaf, and speech to the mute.

Jesus cured lepers, the lame, and even raised the dead. Moreover, Jesus commanded his disciples to “heal the sick, raise the dead, cleanse the lepers” (Mt 10:8) and promised them divine assistance in this work (Jn 14:12). So, in serving the sick and caring for the dying, Christians are fulfilling an apostolate, not just a job. The Church is the Body of Christ, the extension of Christ in space and time; and so healing physical sickness, injuries, and caring for the dying constitute part of the Church’s specific mission.

But, one might ask, why did Jesus himself heal the physically sick and injured? Didn’t Christ become man in order to proclaim the kingdom, die for our sins, and form a Church to carry on that work? Jesus healed partly because he simply cared for the physical well-being of the sick and injured who were brought to him. But he also healed physical maladies as part of his larger mission of proclaiming and making present his kingdom. This means that the salvation Jesus offers is not a purely spiritual reality but includes our whole selves, body and soul. The complete victory is reached only in being joined to Christ in the resurrection. Only then is death is fully conquered. But, lest salvation be identified as something purely spiritual — only for part of us, not the whole of us — followers and imitators of Christ have been commissioned to cure the sick and care for the suffering and dying.

A second reason for Catholic health care can be understood by comparing it to Catholic schools, especially Catholic universities. Of course, learning also occurs in non-Catholic universities — physics, chemistry and biology, for example, do not depend on revealed truths. But the whole of learning — an accurate view of the world as such, and of its ultimate purpose — can be grasped only in a broad study crowned by theology and pursued in the context of faith and theology.

Analogously, sickness and suffering can be treated by medicine and secular social work, but they can be treated most effectively only in the larger context provided by our faith. Only in this context can they be treated with realism and an appreciation for their ultimate meaning. Only the Catholic health care institution has the resources to treat the whole person — body, mind and spirit.

Catholic health care is founded on the faith that sheds light on the profound dignity of each and every human person — made in God’s image, a person for whom Christ suffered and died — a dignity inherent in that person from the moment of conception until natural death, especially including persons enduring intense suffering, frustrating unconsciousness or advancing dementia.

Our faith reveals that suffering is not meaningless. While suffering should be treated, it finds meaning as joined to Christ’s sufferings. And by faith we know that death, while in itself bad, is not the worst enemy; we will be raised from the dead, and we have trust that by God’s grace we will meet again in heaven. Sickness, suffering and death are realistically confronted only with the light provided by our faith.

What lessons can we learn from these truths about Catholic health care? First, Catholic health workers must remember that the Christian mandate is not just to cure the sick. Jesus’ physical healing was only part of a larger, more encompassing cure, centered on the forgiving and redeeming of sins, the infusion of divine life. And it was precisely his insistence on addressing the whole person — sin, as well as physical sickness — that triggered the most fierce resistance against his mission. Just so, the aim of a Catholic health care institution can never be only to cure the sick, but — just as Jesus did — to care for health within the larger context of bearing witness to the truth of the whole Gospel and handing on Jesus’ salvific deeds, especially the Sacraments.

Second, the more encompassing healing is related to physical healing somewhat as faith is related to reason. Just as many Catholic schools are tempted to conform to standards set by the secular world of learning and to dilute their Catholic identity, Catholic health care facilities must resist a similar temptation and strive not to forget their specifically Catholic mission. This is not just a temptation with respect to particular ethical issues. Rather, faith must permeate the whole approach of the Catholic health facility to sickness, suffering, and death. Then, we pray, at the end of the world, Our Lord will say to us, “Come, you who are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world” (Mt. 25: 34).

Patrick Lee, Ph.D., is the John N. and Jamie D. McAleer Professor of Bioethics and the director of the Institute of Bioethics at Franciscan University of Steubenville.