Tag Archives: healthcare

Back pain – the downside of being upright

In any group of people, asking about back pain will produce nods and frowns. About 80 percent of adults experience low back pain at some point in their life, and it’s the most common cause of job-related disability, a leading contributor to missed work days. About 20 percent of people affected by acute low back pain develop chronic pain.

Back pain is often associated with general degeneration of the spine due to normal wear and tear with aging. The discs begin to lose fluid and flexibility, which decrease their ability to cushion the spine. The likelihood of back pain also increases among people who are not physically fit. An increasing amount of research points to a hereditary component, identified by DNA analysis of families with widespread back pain. Jobs that require heavy lifting, pushing, or pulling have a higher incidence of back pain. At the opposite end of the physical demand spectrum, a desk job may also contribute to back pain, as the sitting position increases the pressure within the lumbar discs. Finally, there is clear evidence that smoking leads to premature degeneration of the lumbar discs, with an increased likelihood of back pain.

Fortunately, surgery is rarely indicated, and there are a multitude of useful nonsurgical treatments, including the application of heat and/or cold and massage. Recommendation for bed rest should be limited, as those who avoid bed rest are more likely to improve faster. Other common treatment methods include over-the-counter medications, physical therapy, and spinal manipulation. More involved but less frequent options can include spinal injections provided in a pain clinic.

Once chronic back pain has developed, the emphasis should be on maximizing symptom management. For those with a desk job, standing and walking frequently during the work day can be very helpful. Ergonomically designed furniture, such as standing desks and lumbar support chairs, may help to reduce symptoms, with particular attention to the most appropriate height for the work surface.

The benefits of a regular exercise program as the most effective tool for management of chronic back pain have been clearly demonstrated. The most important factor is to identify an individual program that works best, and then remain committed to it. This can include walking, swimming, cycling, yoga, low-impact aerobics, and many other regimens.

Affliction of back pain has been noted throughout human history. With our upright posture, the spine bears significant stress regardless of our level of activity. The future of spine care will be best focused on improved means of preventing the degenerative changes that lead to back pain, as well as identification of the most effective and consistent means of diminishing its impact.

TIMOTHY MILLEA, M.D. has practiced as an orthopedic spine surgeon in the Quad Cities area of Iowa and Illinois since 1992. He is an active member of the Catholic Medical Association and serves on the board of directors, as well as being CMA’s state representative for Iowa, and president of the St. Thomas Aquinas Guild of the Quad Cities.

HealthNetwork came to our rescue like no other

There are so many benefits to being a Legatus member. One that I consider a Godsend is Healthnetwork Foundation. Many years ago, Walter and I became Healthnetwork GOLD supporters, as I thought that it would be a great safety net – an organization we could count on when we needed medical help.

It is scary as you get older and see more friends and family struggle with serious health issues, and the overwhelming indecision they face while trying to grasp their new reality. Where do they go for medical care, how do they get there, and whom do they see? All these decisions need to be made in a very short time, while they try and make sense of a diagnosis.

We are so grateful for Healthnetwork. We know from experience they will provide advice on where the right experts are. And, they will quickly jump into securing appointments with experts when we need them.

I had a heart attack a few years ago in Florida, and Walter called Healthnetwork. Without hesitation, Healthnetwork medical coordinators rallied and made connections on our behalf at Cleveland Clinic (#1 heart center as ranked by US News & World Report). Ultimately, I stayed in Florida for treatment, but we were reassured by the swiftness and compassion shared by our coordinator during a very stressful time.

Another time, our daughter, an anesthesiologist, was very concerned about her baby daughter’s soft spot which had not closed. I knew that we needed to get Healthnetwork involved. She asked for more information about the issue and Healthnetwork’s medical director provided research on the condition. They also identified experts who were available to see our granddaughter. She is now a very busy 12-year-old and a champion swimmer.

Walter and I are blessed with good health. Healthnetwork has proven very resourceful in providing physician referrals during the times we needed them most. We have also asked for help for dear friends. One friend had a serious heart issue. Because of Healthnetwork, he was put under the care of Mayo Clinic and lived another seven-plus years.

There are many more stories of families they have helped. Those who call upon Healthnetwork receive an outstanding level of care. Families have the privacy to explore their options. Healthnetwork offers guidance and connections at a very critical time. Because of our gratitude for the life-changing connections we have seen, we have increased our support levels with Healthnetwork.

We encourage other Legates to reach out to Healthnetwork. They are a phenomenal team whose resources are just what is needed when one is faced with stymying medical issues.

WALTER AND JANET KNYSZ are Legates of the Detroit Chapter

Crisis in healthcare – a Catholic perspective on reform

The healthcare crisis in America Today is twofold: ethical and economic.

The ethical crisis is the denial of the sanctity of human life from conception to natural death that has resulted in the abortion of tens of millions of unborn Americans and the physician-mediated deaths of many seriously disabled and terminally ill patients by physician-assisted suicide in the nine jurisdictions where it is legal. 

Additionally, the constitutional right to religious liberty and freedom of conscience is denied those who refuse to comply with federal mandates to provide patients with contraceptive/abortifacient drugs. No proposal for healthcare reform can receive Catholic support if it does not uphold the universal and inalienable right to life and religious liberty.

The economic crisis arises from control of healthcare financing by third parties, (government, insurance industry, unions, and large employers). For the last 50 years this system has insulated patients from the actual costs of care and removed the normal economic incentive to shop based on price and value, thereby contributing to the astronomical rise in costs. Although healthcare outcomes have certainly improved for most people, the rising costs have led to problems of affordability and access for too many Americans. This system is unsustainable. 

Political decisions made over the next 12 – 24 months will likely determine the foreseeable future of healthcare delivery in America. The current national debate focuses on two fundamental proposals: a government controlled, single-payer system vs. a patient-controlled, competitive free-market system.

Those promoting a government-controlled system of healthcare delivery insist upon universal access to contraception and abortion. Based upon experience with the Affordable Care Act, no one would be exempt from compliance with the mandates for care determined by the federal government (i.e., one-payer, one ethic). In contrast, in a patient-oriented, free market system, options would be available to avoid cooperation with evil (room for pro-life ethics).

No government-controlled health care program has proven capable of “bending the cost curve” downward to rein in unsustainable rising costs.

However, evidence from a landmark 1982 RAND study demonstrates that giving patients freedom and choice to control their health care, including financing reduces costs. Also, newer innovations for financing care including health savings accounts, employer-sponsored health reimbursement arrangements, direct primary care, and healthcare sharing ministries, all show promise for lowering costs and increasing access while maintaining high-quality care and enhancing the doctor-patient relationship.

As Catholic lay leaders we have a duty to uphold our faith in our work and in the public square. If we come together to address this crisis in healthcare, and if every Catholic employer offered one or more of the above patient-centered, market-driven innovative options in a faith-based health plan, we would begin the transformation of our healthcare delivery system, defending human dignity and religious liberty while restoring a culture of life in America.

STEVEN WHITE, M.D. has been in the private practice of pulmonary medicine for 35 years. He is a past-president of the Catholic Medical Association and currently serves as chair of the CMA Healthcare Policy Committee.

Following the Doctor-Saint of faithful medicine

Through medical clinics that bear her name, St. Gianna Molla continues to provide health care to families around the globe while proving to society that modern medicine can be practiced along ethical and religious guidelines.

Two Legates who are physicians – Doctors Max Mercado in Philadelphia and Robin Goldsmith in Green Bay, Wisconsin – have drawn inspiration from the 20th century Milanese pediatrician who was a devout Catholic, wife, and mother who sacrificed her own life in a troubled pregnancy so that her fourth child could be born.

Mercado and Goldsmith have opened clinics named for St. Gianna Molla in their respective cities, who was canonized in 2004 by Pope St. Pope John Paul II. Though she died in 1962 at age 39, St. Gianna’s story and her pro-life example continues to inspire people around the world. The Legates who have opened clinics under her patronage believe St. Gianna has a role to play in reforming medicine and ushering in a true culture of life.

PHILADELPHIA – HONORING SANCTITY OF LIFE, MARRIAGE

The Gianna Center of Philadelphia opened in March after about a year of planning, said Mercado, the president of Legatus’ Bucks County Chapter who will serve as the center’s CEO.

“The goal and purpose of the Gianna Center of Philadelphia is to lay down a foundation for the culture of life to flourish in the lives of individuals and families,” said Mercado, adding that the clinic offers general gynecological care, natural family planning education, and infertility services.

Those services are provided while honoring the sanctity of human life, the dignity of women, and the integrity of marriage.

“We are following the teachings of the Church,” said Mercado, who explained that the St. Gianna Center does not provide services such as in vitro fertilization. To assist couples experiencing difficulty conceiving, the clinic uses NaProTechnology, a medical and surgical technique used to treat the direct source of various gynecologic and reproductive health conditions.

“We also refer to social services families that are in need,” Mercado said. “And as a mission, we seek to provide pro-life reproductive health care to women and families that follow the bishops’ ethical and religious directives for Catholic health care services.”

The Catholic community in Philadelphia, a city with a large number of medical schools, encountered St. Gianna’s story during the World Meeting of Families that was held there in 2015. St. Gianna’s youngest child, Gianna Emanuela Molla, (herself a physician), attended the event and shared her testimony of growing up as the daughter who was saved by her saintly mother. St. Gianna was also a co-patron of the event.

“This is a saint who captures the imagination of a lot of young women who are exposed to secularism and the culture of death,” Mercado said. “We’re saying to them, ‘Come out of darkness. Come into the light.’”

The Gianna Center of Philadelphia is located in the city’s northeast section and is affiliated with the National Gianna Center Network, which has a string of clinics in New York, New Jersey, Kansas City, and Wisconsin.

The clinic in Philadelphia is also staffed with Dr. Delia Larrauri and Barbara Rose, a nurse practitioner, providing direct care for women and families. Mercado said he and the center’s staff and directors have been getting the word out to local Catholic agencies. Archbishop Charles Chaput of Philadelphia has also given the center his blessing.

“The centers are pro-woman, pro-families, and they’re prolife,” Mercado said, adding that there is a need for medical facilities that offers women’s health and fertility services through a pro-life perspective. All too often, OB-GYN practices in Philadelphia and across the country see no problems with prescribing birth control pills to address a variety of conditions such as menstrual cramps and irregular cycles.

“There are other treatments besides oral contraceptive pills,” Mercado said. “I mean, what are we doing here? Are we really giving choices to women or are we just going along with whatever the common treatments are and forgetting about the women’s beliefs?”

Being named for a 20th century woman who went to medical school, got married in her 30s, had children, worked as a physician, and is a canonized saint in the Catholic Church can only help the clinic’s mission.

Said Mercado, “Her life is an amazing story.”

GREEN BAY – LAUNCHED BY FEMALE PHYSICIAN AND MOTHER

Dr. Goldsmith, a member of Legatus’ Northeast Wisconsin Chapter, was praying in Eucharistic adoration when St. Gianna’s name came to her mind.

“I knew almost nothing about St. Gianna. I knew her name, but very little about her,” said Goldsmith, who a few years ago was asked by a fellow Legate to launch an initiative to bring back “faithful medicine” because the medical field was headed “in the wrong direction.”

Asked to think about it, Goldsmith said that for several weeks she prayed, pondered, and discussed the idea with friends and family. Eventually she concluded that something had to be done in the form of a Catholic medical clinic that took care of all people.

“You see women’s clinics, you see family practice clinics, but there aren’t many clinics that really emphasize taking care of everyone from the beginning of conception to natural end of life,” Goldsmith said. “Everyone needs to be cared and loved in dignity and respect according to our faith.”

After deciding to start a new clinic under St. Gianna’s patronage, Goldsmith said she scheduled a meeting to get the approval of Bishop David L. Ricken of Green Bay. The bishop loved the idea, gave her his blessing and asked what she planned to name the clinic.

Before she could answer, the bishop told Goldsmith that St. Gianna’s name had come to him in prayer. Stunned, Goldsmith said she had had a similar experience. The bishop replied, “Well, of course it did. That’s the Holy Spirit.”

“It’s been one event after another just like that,” said Goldsmith, who noted that many of the clinic’s major events, such as its opening day and consecrating Mass, have occurred on Marian feast days.

“We feel very strongly that Mary has been very involved in making this clinic unfold,” said Goldsmith, the president and chief medical officer of the St. Gianna Clinic in Green Bay.

The clinic is aligned with the Hospital Sisters Health System, and is located across the street from HSHS St. Mary’s Hospital Medical Center. The clinic offers family medicine and a complete range of OB-GYN services and treatments, including pregnancy and fertility care. The clinic is staffed by Doctors Scott Stillwell and Melissa Weidert.

Like its counterpart in Philadelphia, the St. Gianna Clinic in Green Bay does not provide treatments that violate Church teachings. The center offers NaProTechnology and uses the Creighton Model Fertility Care System to diagnose a woman’s specific health condition.

“The approach is very beautiful. It’s about restoring a woman’ body back to health instead of just covering it up with medication,” Goldsmith said.

In addition to medical services, the clinic offers spiritual support. The staff prays together and with patients. In the waiting room are first and second class relics of St. Gianna Molla.

“Personally for me, I feel an incredible closeness to St. Gianna because she was a female physician, a mother of four, as am I, and a wife who was extremely pro-life and loved to teach about the faith, especially as it pertained to medicine,” said Goldsmith, who hopes her clinic will be one of many such facilities across the country that will change the face of Catholic healthcare in St. Gianna’s image.

“She completely embodies what we do here at the St. Gianna clinic,” Goldsmith said. “We believe that every life is beautiful, every life is worthy of respect, honor and dignity. Just as she honored every patient and every life that she encountered, we try to do the same here.”

BRIAN FRAGA is a Legatus magazine staff writer.

 

Medicine’s ‘hospitality’ birthed in Christianity

The hospital, as an institution, burst suddenly onto the scene in the fourth century. It came as if out of nowhere, and in a half-century it was everywhere.

Pagan antiquity had had all the material ingredients for such an institution. The Greeks and Romans had doctors. There was ample demand for medical treatment. And yet neither Greeks nor Romans — nor Chaldeans, nor Egyptians, nor Persians — had ever produced a hospital.

The foremost expert on the early history of hospitals, Dr. Gary Ferngren of Oregon State University, states this emphatically: “The hospital was, in conception, a distinctively Christian institution, rooted in concepts of charity and philanthropy. There were no pre-Christian institutions in the ancient world that served the purpose that Christian hospitals were created to serve.”

In classical antiquity, there were many professionals in the healing arts. The medical field was a riot of different types of practitioner: herbalists, soothsayers, magicians, folk healers, as well as those who practiced Hippocratic or “empirical” medicine. There were no certification boards. There were no medical schools to grant diplomas. Healers usually underwent an apprenticeship with someone more experienced.

Many practitioners in antiquity made their living wandering from town to town, perhaps outrunning the public response to their latest failures. Some crossed continents in the course of their careers. Their clientele consisted of those who could pay.

These wandering doctors had no roots, no local loyalties, no lasting accountability. There was no institutional form available to them. Yet there was great demand for medical care. Pain, sickness, and discomfort are characteristic of the human condition since the Fall of Adam. And those who suffered went looking, sometimes desperately, for relief.

We see something interesting happen in the early Christian centuries. We know, from documentary and archeological evidence, that doctors made up an unusually large portion of the early Church. In fact, they are represented more than any other professional group. Christianity was soon known as a source of healing in the world.

Christian doctors were different from their pagan colleagues. They would take no part in abortion, assisted suicide, cosmetic castration, or infanticide — all of which were common in ancient times. Nor would they prescribe contraceptive drugs.

But that’s not all they refused to do. They also refused to turn patients away.

When a smallpox plague hit the empire in 250 A.D., many doctors fled the cities. In its deadliest phase, the disease killed thousands of people per day in Rome alone — and raged intermittently for at least 20 years.

Christian doctors didn’t flee. They stayed and tended the sick. St. Cyprian exhorted his congregation in Africa to care not only for fellow Christians, but for their pagan persecutors as well.

It was probably then that the idea of the hospital first emerged — when house churches were offered in “hospitality” to the sick who had been abandoned.

When another plague struck, 70 years later, Christians everywhere knew how to respond. The churches became refuges, where the sick could find food and care. It was the only care available to them.

Shortly afterward, Christianity was legalized, and hospitals appeared everywhere. No city could be without one. Some cities had a halfdozen. Soon, most cities also had forms of ambulance service.

Once established, Christian hospitals became de facto research institutions — where professionals could observe the way illnesses progressed in multiple patients.

The hospital could not have happened without Christianity. Pagan societies had the material resources to invent it. But they lacked the spiritual resources. They lacked a belief in charity — self-giving love — as a share in the life of God. They lacked the belief in human dignity and universal brotherhood. They were unaware of the divine command to heal and show hospitality to friends and strangers alike, and even to enemies.

The hospital did not arise in a pre-Christian world. We should wonder, then, whether it can survive long in a post-Christian world.

MIKE AQUILINA is the author of The Healing Imperative: The Early Church and the Invention of Medicine as We Know It. He has written more than 50 books on Catholic history, doctrine, and devotion. He has hosted 10 series on EWTN Television, and appears weekly on Sirius Radio’s “Sonrise Morning Show.”

Treating the frail as Christ did

Catholic health care has always seen its mission of providing healing and compassion to the suffering as an extension of the healing ministry of Christ.

In his 1995 encyclical The Gospel of Life, St. John Paul II wrote that health care personnel have a “unique responsibility” in that their profession “calls for them to be guardians and servants of human life.”

“Health care professionals,” the Catholic bishops of the United States have stated in a similar vein in their Ethical and Religious Directives for Catholic Health Care Services, “pursue a special vocation to share in carrying forth God’s life-giving and healing work.”

Recently a few Legates who are doctors shared how their Catholic faith intersects with their work in the medical profession.

Compassion for the most vulnerable

As an ophthalmologist who specializes in retinal problems, Dr. Kenneth Diddie has spent many years screening premature babies in neonatal intensive care units (NICUs) for retinopathy of prematurity (ROP), a common but sometimes serious condition. Lowbirthweight babies born at 24 or 25 weeks’ gestation are the most prone to developing ROP.

“If I find threshold levels of this condition, I perform laser treatment on the baby’s eyes in the NICU to prevent retinal detachment and blindness,” explained Diddie, a Legate of the Ventura/LA North Chapter in southern California.

That work, along with Church teaching on the sanctity of human life, helped spur his conversion to Catholicism in 2001. What caught his attention was the debate over restrictions on late-term abortions, in which “prochoice” organizations argue that abortion should remain legal and available throughout pregnancy, even up to 40 weeks.

“When I heard people defending late-term or partial-birth abortion, it was clear to me that they were okay with killing babies older than those I was screening and lasering,” said Diddie, who was Episcopalian at the time.

“The fact that the Catholic Church was opposed to aborting human life at any age was a major factor in my joining the Church.”

Although he also treats adults, Diddie is particularly passionate about treating premature infants, which he says “are the most vulnerable and at risk.” Many of his young patients face other physical and socio-economic hurdles, so he will treat them regardless of their families’ insurance coverage or ability to pay. “I want to make sure, to the best of my ability, that they do not have the additional burden of decreased vision or blindness,” he said.

He hopes his actions — his compassion and care for his patients — speak louder than words: “Even though I do not go around blowing my own trumpet, I think my attitudes are not lost on those in our office or in the hospitals.” His efforts come with rewards. “Several years ago, the mother of one of the babies that needed laser treatment sent me a photo of her son graduating from college,” Diddie recounted. “She thought I would like to see how my work had been beneficial to him. “That outcome, compared with what was possible as recently as 60 years ago, is indeed miraculous.”

Using God-given talents to serve others

Dr. Stephen A. Olenchock, chief of cardiovascular surgery at St. Luke’s University Health Network in Bethlehem, PA., believes Catholics should let faith guide their work regardless of profession, including health care.

“Daily, as a cardiac surgeon, you may be introduced to new people who may have serious medical conditions which placed then in a vulnerable situation both physically and emotionally,” said Olenchock, a Legate of the Lehigh Valley Chapter. “My Catholic faith tells me to attempt to meet people where they are, and to try to use my God-given talents to the best of my ability to help care for others.“

Olenchock has performed some 800 cardiac surgeries, most of them involving heart valve procedures. It’s a serious undertaking that goes well the majority of the time, but occasionally difficult situations arise. He may have to help families deal with the loss of a loved one, or to prepare them to deal with the stress and challenges when a patient requires a long recovery.

“Some of these situations affect not only the families of patients, but the entire staff of caregivers involved with the patient,” said Olenchock. “I very frequently, although privately, pray for my patients and their families, especially in these very difficult situations. I often pray for God just to give me the strength to use my talent to the fullest, and this helps me in the stress of situations.”

On many occasions — often in unexpected, miraculous ways — his experiences as a surgeon has strengthened his faith in God, he said. The “most memorable” case involved emergency surgery he performed on a patient whom he felt certain would not survive the operation. “I actually remember thinking that everything I am doing to try to save this person was not working, and it seemed as if I was actually trying to stop something God had planned,” he said. When the patient “miraculously survived,” it was clearly due to something more than the medical intervention provided.

“I personally witnessed the power of prayer from his family and from all of the medical providers,” said Olenchock. “This was a big part of my own personal faith journey, and really helped strengthen my belief in God and life ever after in his Kingdom of Heaven.”

For ‘the least of my brothers’

Dr. John Marta, a Colorado Springs (CO) Chapter Legate, has retired from the practice of anesthesiology, but he gladly continues to give public talks about his favorite subject, the Holy Land.

A native of Jerusalem who immigrated to the United States in 1960 to attend college and medical school, Marta came from a devoutly Catholic family and received his early education in Franciscan schools. His father was a longtime Catholic school principal as well as an official organist to the Holy Land, where he played for the High Masses at Jerusalem’s Basilica of the Holy Sepulchre and for the Christmas Midnight Mass at Bethlehem’s Church of the Nativity. His mother, who converted to Catholicism, was the daughter of a Greek Orthodox elder in Bethlehem.

“My faith has always been in the forefront of my professional life,” said Marta, who retired in 2014 after more than four decades of private practice in Colorado Springs, where he was a longtime chief of anesthesia at Penrose Hospital and operated a pain-management clinic. When appropriate, he would pray with his patients before surgery. “Patients would request me for future surgeries and ask me to pray with them,” he said. “This, to me, was powerful.”

A mystical experience early in his medical career brought him a fresh appreciation of his work as a vocation to serve the poorest and neediest of society, he noted.

“As a naive young anesthesiologist, I would occasionally complain to myself when I would be awakened at two o’clock in the morning to report for surgery on a disheveled, smelly patient who was vomiting all over himself, knowing fully well this person had no insurance,” he recalled.

On one such night of interior grumbling, Marta heard a very clear “voice” telling him, “John, this person is ‘one of the least of my brothers.’

That moment of revelation changed him. “From then on, taking care of ‘all of these people’ became a duty and a privilege for the rest of my professional life,” he said.

It changed his patients, too, it seems. “At my retirement, many of my disadvantaged patients came to say goodbye, and we cried together,” Marta said. “They said to me: ‘You are the only one who was willing to take care of us without expecting payment. Who is going to take care of us now?’

“I assured them that there are many wonderful Christian doctors who are willing to do the same for them,” he said. Marta said he witnessed so many miracles during his years of practice that he “took them for granted.” What stands out above all, however, are the miracles of birth.

“I don’t know how anybody who observes these miracles can ever deny them,” he said.

GERALD KORSON is a Legatus magazine staff writer.

Keeping Catholic health care on-mission and on-message

Annette M. Walker, a Legate of the Orange Canyons (CA) Chapter, is president of strategy at Providence St. Joseph Health, which oversees 50 hospitals and 829 clinics across five states, and chief executive of St. Joseph Health System. She recently answered a few questions for Legatus about her work as a Catholic health care executive.

LEGATUS: How does your Catholic faith infuse your professional work? Conversely, how does your professional work affect your faith?

WALKER: My Catholic faith influences everything in my life, including how I approach my work and how I engage with others. The best way to look at it is that I work for a Catholic ministry that happens to operate in the American health care industry. I am constantly reminded of and challenged to live up to that expectation.

It is not enough to be a good leader or manager; decisions need to be made in the light of a ministry. For example, a layoff for financial stability in most American businesses might be fairly simple. In Catholic health care, questions about justice, disproportionate impact on low-wage vs. high-wage earners, and dignity are paramount concerns that must also be addressed.

LEGATUS: What are some of the challenges of ensuring that health services are provided in accordance with Catholic social teaching? How do government regulation, the insurance industry, and pressures of public opinion impact the delivery of authentically Catholic health care?

WALKER: The Catholic health care tradition is the healing ministry of Jesus. Most days it is easy to see and feel God’s presence – especially in the provision of care – but it’s always good to ask yourself the question – “What would Jesus do?” If you ask yourself that question, odds are you will do the right thing. My ministry is particularly faithful in its commitment to the poor and vulnerable. Catholic health care is continually challenged by public perception and a focus on what we won’t do – for example, abortion.

There isn’t enough attention to all that we do and the many ways we help our communities. We care for people no one else cares for, support women and children, provide food, housing and educational opportunities in addition to providing excellent and comprehensive health care that improves the health of the communities we serve. That being said, there is intensive pressure to apply secular beliefs on Catholic institutions, particularly in the areas of respect for life — all life.

LEGATUS: What kind of adjustments have Catholic health care organizations had to make in order to deal with changes in health care laws and regulations?

WALKER: We are operating in the complex world of American health care which is becoming more challenging every day. At times, it would be easier to separate ourselves and try to operate in a silo. We recognize, however, that that fulfilling our mission as Catholics means being in the world and witnessing that God is present and accounted for. So we persist. We stand on the things we must, we find partners with whom we can find some common ground of good, and we advocate for those who cannot advocate for themselves.

ObamaCare and you

The new health care law will affect every single American and every business owner . . .

Adam R. Kaufman

Adam R. Kaufman

This spring President Obama signed into law a major overhaul of the U.S. health care delivery system. Other than the federal stimulus and financial bailouts, the new health care law garnered more attention than any other legislative pursuit in 2010. As well it should.

At a cost of at least $940 billion over the next 10 years, the new law will have a major impact on every aspect of medicine and the delivery of health services in America. Who will be affected? The simple answer: everyone. Having helped thousands of presidents, CEOs and entrepreneurs access the very best hospital care for eight years through Healthnetwork Foundation, I’ve heard much about the law’s impact on our health system from each segment of the industry.

Officially named the Patient Protection and Affordable Care Act (PPACA), debate nonetheless continues regarding what benefits (or lack thereof) the enormous federal law will create. PPACA says it will cover 32 million uninsured by 2019. Dependent coverage extends to age 26. No lifetime limits. Auto enrollment of employees in company health coverage. No rescission of coverage (except for fraud). States will set up health insurance “exchanges.” The Internal Revenue Service will be more involved in health care oversight.

Because the law costs so much and affects so many aspects of society, most provisions will be phased in. In 2011, restrictions and penalties on the use of Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) will become law. In 2012, W-2 tax forms must state the value of employer contributions to health coverage. In 2013, companies must provide employees with formal notice that health coverage is also available through Exchanges (set up and administered by the federal government). In 2014, there will supposedly be no waiting periods beyond 90 days.

Everyone agrees that we should make our health system more efficient and effective. Yet, because the new law elevates the federal government to such a preferred position, every Republican in the House and Senate voted against the bill. Since passage, 20 states have filed suit against all or some aspect of the new law, and a petition to essentially repeal the law, introduced by Rep. Steve King (R-Iowa), is gaining traction.

It’s important that we understand how the law will affect us as citizens and as business leaders. During the health care debate earlier this year, I asked leaders at the nation’s top hospitals what they thought of the bill. These leaders employ tens of thousands of employees — and their “product” is directly affected by the new legislation. So I wondered why more hospital CEOs didn’t take a public stance.

Three hospital leaders confidentially told me the same thing: because they run multi-billion-dollar organizations which depend on government payment, government certificates, tax rulings and their non-profit status, they didn’t feel comfortable putting their hospitals’ standing in jeopardy by criticizing the legislation. Privately, they’re concerned about the decreasing reimbursement rates that will surely come; they’re concerned that an already-constrained system with too few doctors and nurses will be further burdened when a previously uninsured 32 million people begin seeking care.

According to the National Small Business Association, an alarming 79% of entrepreneurs say they have limited (62%) or no understanding (17%) of how the new health care law will affect business. Jay Schreibman, president of LSG Insurance Partners in Bloomfield Hills, Mich., told me that his clients are only beginning to understand the administrative burden the new law will have on their companies. A leader in corporate benefits programs, Schreibman laments, “You will never lift the wage earner by burdening the wage payer.”

More bad news for the cost-conscious and businesses: According to the Heritage Foundation, a Washington-based think tank, the new law increases the threshold to itemize health expenses from 7.5% to 10% of adjusted gross income beginning in 2013; seniors over age 65 would receive a four-year extension of the 7.5% income threshold (until 2017). This provision will raise taxes by $15.2 billion. The bill also repeals the current-law tax deductibility of subsidies provided to companies offering prescription drug coverage to retirees, raising taxes by $5.4 billion. Many say this provision will lead companies to drop their coverage as a result.

Rather than completely overhaul such a substantial portion of our national economy, it would have made more sense to focus first on helping just those 32 million uninsured. Rather than burden the business owners we depend on to drive our weak economy back to promising growth, I would have preferred that lawmakers consider and pass smaller laws, gradually.

Billionaire Michael Milken is at the forefront of health care policy, having started the Prostate Cancer Foundation, FasterCures and other health organizations. Milken recommended changes focus on personal responsibility, such as rewarding individuals who lose weight with lower health insurance rates, just as we reward safe drivers with preferred car insurance rates.

Let’s hope that more focus on personal responsibility and free market solutions will be available to Legatus members and all Americans in the coming years as the health care debate continues.

Adam R. Kaufman is the co-president of Healthnetwork Foundation, a Cleveland-based nonprofit that provides executives with access to the best hospitals in the world.

Life issues faced by Catholic business leaders

Andrew Abela continues his series on the forthcoming Catechism for Business. . .

Dr. Andrew Abela

This column continues its look at four questions from the forthcoming Catechism for Business (see September 2008 column). We focus here on life issues, covering four relevant questions.

May we sell any product or service to an organization whose purpose is hostile to innocent life?

The Church draws a distinction between formal and material cooperation with evil. Formal cooperation is where your intention or your own action is evil. Material cooperation with evil is where you do not share the evil intention of those you are cooperating with, and where your own action is not evil, but somehow contributes to the evil action of another. In this example, offering cleaning services to an abortion clinic because you support what they are doing is formal cooperation. Offering cleaning services to an abortion clinic because you need to keep your workers employed in a recession, while you despise what is going on in the clinic, is material cooperation.

Formal cooperation is always forbidden. Material cooperation should be avoided, except where avoiding it would cause a greater evil. In cases of attacks on innocent life though, even material cooperation is forbidden, because there can be no greater evil than the taking of an innocent life. Therefore, it is not permissible to sell cleaning services to an abortion clinic, even to save your employees’ jobs.

“Formal cooperation is carried out when the moral agent cooperates with the immoral action of another person, sharing in the latter’s evil intention. On the other hand, when a moral agent cooperates with the immoral action of another person, without sharing his/her evil intention, it is a case of material cooperation.

“Formal cooperation is always morally illicit because it represents a form of direct and intentional participation in the sinful action of another person. Material cooperation can sometimes be illicit … but when immediate material cooperation concerns grave attacks on human life, it is always to be considered illicit.”—Pontifical Academy for Life, Moral Reflections on Vaccines Prepared from Cells Derived From Aborted Human Fetuses, June 5, 2005.

Is it morally acceptable to offer health care benefits that cover abortion or birth control to employees?

The answer to this question is similar to the preceding one: Offering health care benefits that cover abortion or birth control to employees is at best material cooperation in evil, and since in the case of abortion and (often) birth control this involves an offense against life, then it is not permissible.

Should health care workers refuse to participate in actions that are harmful to innocent life?

Health care workers should exercise their right to conscientious objection when asked to participate in any attack on innocent human life (i.e., abortion or euthanasia). Where this right is not recognized, health care workers must still refuse to participate in such attacks, even at the cost of their own career because — as just noted — even material cooperation in attacks on innocent life is forbidden.

“In the moral domain, [the International Congress of Catholic Pharmacists] is invited to address the issue of conscientious objection, which is a right your profession must recognize, permitting you not to collaborate either directly or indirectly by supplying products for the purpose of decisions that are clearly immoral.”— Pope Benedict XVI, Address to the ICCP, Oct. 29, 2007.

“The passing of unjust laws often raises difficult problems of conscience for morally upright people with regard to the issue of cooperation since they have a right to demand not to be forced to take part in morally evil actions. Sometimes the choices which have to be made are difficult; they may require the sacrifice of prestigious professional positions or the relinquishing of reasonable hopes of career advancement.”— Pope John Paul II, Evangelium Vitae, #74.

What obligations do we have to ensure the health and safety of our employees beyond the legal requirements, especially in countries with less stringent legislation?

Respect for human life requires employers to take every precaution to protect the lives and health of their employees. The Church notes the importance of protecting workers’ moral as well as physical health. Employers also have a responsibility for the safety of the employees of their outsource partners, whom the Church considers their indirect employees.

“Among these rights [of employees] there should never be overlooked the right to a working environment and to manufacturing processes which are not harmful to the workers’ physical health or to their moral integrity.”— John Paul II, Laborem Exercens, #19.

“The conditions in which a man works … must not be such as to weaken his physical or moral fiber, or militate against the proper development of adolescents to manhood.” — Pope John XXIII, Pacem in Terris, #19.

“The responsibility of the indirect employer differs from that of the direct employer … but it remains a true responsibility: The indirect employer substantially determines one or other facet of the labor relationship, thus conditioning the conduct of the direct employer when the latter determines in concrete terms the actual work contract and labor relations. — Laborem Exercens, #17.

Dr. Andrew Abela is an associate professor of marketing at the Catholic University of America, where he is chair-elect of the Department of Business and Economics. He lives in Great Falls, Va., with his wife Kathleen and their six children.

Making a difference by accessing top healthcare

Joseph Janiczek understands the value of his Legatus Healthnetwork benefit. A member of the Legatus Board of Governors, chairman of Janiczek and Co., and a Healthnetwork GOLD supporter, Janiczek has called upon Healthnetwork on several occasions. Each time he was provided with expedient solutions.

“As soon as I got a taste for Healthnetwork, I was sold on the value of their services,” Janiczek says. “Healthnetwork Foundation has an impeccable reputation for excellence. Their ability to offer access to healthcare is a great service for Legatus members. In fact, I became a Healthnetwork GOLD supporter because they provided such great service to people who are very important to me.”

Janiczek’s first call to Healthnetwork was for his father, who required shoulder surgery. Once his father decided to proceed with surgery, he wanted it done quickly. After trying valiantly on his own to secure appointments with a specialist, Janiczek’s father grew frustrated with how long he would have to wait for an appointment.

“I called Healthnetwork on my father’s behalf and he was connected with an incredible expert near him very quickly,” Janiczek says. “Within a week of my call, the liaison at the hospital secured an appointment for him and he had his surgery a week later. He is very pleased with the expediency and grateful for the connection to such a talented physician.”

Janiczek then learned that his niece had an abnormal cyst in her hip area, again prompting him to call Healthnetwork. Her treating physician recommended a specialist, but getting an appointment with this specialist just to diagnose the medical condition was many days longer than the family wanted to wait.

“I thought to call Healthnetwork again,” he says. “With one call, my niece was able to see a leading pediatric specialist. He made time for her immediately and she had surgery the next day. My family felt like they were in great hands, and my niece received the best medical care.”

Like Janiczek, many of his colleagues are chief executive officers. After talking with a close friend about a medical crisis, Janiczek offered to ask Healthnetwork for help.

“As a board member of Legatus, I was aware of Healthnetwork’s unique services,” Janiczek remarks. “Healthnetwork has a reputation for offering bypass solutions to the medical bureaucracy we all face; their ability to streamline access when we need it means very much to all of us.”

Healthnetwork is your health advocate, poised to assist you and your loved ones to secure appointments with the best physicians at top hospitals across the country.

Kate Hannibal is Healthnetwork Foundation’s marketing manager.

Healthnetwork is a membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. For information on how this can work for you, call (866) 968-2467 or (440) 893-0830. E-mail: help@healthnetworkfoundation.org

Healthcare in America and the Catholic physician

There is a serious healthcare crisis looming in the United States. There are many reasons for this crisis, but its fundamental underpinnings are found in the doctor-patient relationship that changed when medical graduates ceased taking the Hippocratic Oath.

Today the patient is a “client” and the physician is a “healthcare provider.” The relationship is centered on the “fee for service” and the responsible party who pays those fees. The “payor” determines what services will be provided and expects that the physician will provide the service even if it’s not in the patient’s best interest.

Shifting values

Most students enter medical school without realizing that they have, in most instances, responded to a call from God. Students forego sleep, food and time with friends or family as the patients’ needs take priority. However, this sacrificial relationship has been compromised by omitting the Hippocratic Oath’s moral guidelines.

The oath lays the groundwork for the doctor-patient relationship: “I will follow that method of treatment which … I consider for the benefit of my patients. I will give no deadly medicine to anyone if asked, nor suggest any such counsel; furthermore, I will not give to a woman an instrument to produce an abortion.”

The legalization of abortion in 1973 made it impossible to administer the Hippocratic Oath to graduating medical students. Placing the woman’s autonomy above that of her child changed the mother-child relationship with its failure to recognize the inviolability of each human life, but it also began to chip away at the mutual autonomy of the physician and the patient.

Since the legalization of abortion and widespread use of contraception and sterilization in our pluralistic, secular culture, it has become increasingly difficult for Catholic medical students to go on clinical rotations where these practices are happening and enter specialties like obstetrics and gynecology, family practice, urology, pediatrics or internal medicine without compromising their beliefs. Frequently, because of their youth and inexperience, they abandon their faith and follow the secular lead in these practices.

In 1996, the American College of Obstetricians and Gynecologists attempted to mandate that all obstetrics and gynecology residency programs (including Catholic programs) provide abortion training for residents. Fortunately, the federal government stepped. In 2005, Congress strengthened its anti-discrimination statutes.

Last November, however, the American College of Obstetricians and Gynecologists (ACOG) issued an official opinion limiting conscientious refusal. The document placed patient autonomy before that of the physician and said that even if a physician refuses to perform abortions they should refer the patient for an abortion or other reproductive services if asked.

Christian physicians and associations responded to this violation of the right to conscience. In January, the American Board of Obstetricians and Gynecologists (ABOG), the body that certifies Ob-Gyns, changed its board requirements to include adherence to all the ethics opinions of ACOG. This would have ultimately prevented pro-life Ob-Gyns from practicing medicine in the United States. Members of Congress responded to ACOG and ABOG (as did Health and Human Services Secretary Michael Leavitt), reminding these two organizations about the federal laws protecting conscience rights.

Other challenges

Another hot-button issue is Oregon’s legalization of physician-assisted suicide (PAS), which tries to legitimize a practice contrary to the Hippocratic Oath and physicians’ healing ministry. Euthanasia is a grave offense against the dignity of the person seeking it.

There is a ballot measure in Washington to legalize PAS this fall. Pro-death forces hope it starts a chain reaction of states legalizing PAS. Because the population is top-heavy with retirement-aged individuals who will be using a higher proportion of healthcare dollars, it’s easy to see where this is leading. Society has eliminated “inconvenient” children for 35 years. Some want to do the same with the sick, the handicapped and the elderly.

Some believe that nationalized healthcare with a single payor is a solution to our country’s healthcare delivery system. The Catholic Medical Association (CMA) has grave concerns that this will lead to further erosion of the doctor-patient relationship.

In order to alleviate this crisis, there has to be individual ownership of healthcare insurance with refundable tax credits that could be carried from job to job. Large organizations can become self-insured, eliminating practices such as sterilization, contraception, abortion and in vitro from their coverage. Lastly, we need to have comprehensive protection of conscience for Catholic hospitals and physicians. The courts have failed to respect the rights of conscience, necessitating the need to tighten up these laws.

Only through collaboration between the business sector, insurance specialists and the Catholic medical community can we restore the doctor-patient relationship, maintain the autonomy of Catholic institutions and prevent bankruptcy of the finest healthcare delivery system in the world.

Kathleen M. Raviele, MD FACOG, is president of the Catholic Medical Association.