by Max Brantley
The New York Times wrote about this earlier and now Daily Kos has expanded on the theme.
Catholic hospital systems are the largest in the country and their growth has implications for health services, primarily to women (though men have some shared interests in reproductive issues.)
It's a critically important issue in Arkansas, where the state's only teaching hospital, UAMS, is talking about a combination with St. Vincent Health. The Catholic hospital, which already receives tax benefits and publicly financed (Medicare, Medicaid) patients, would qualify for the higher reimbursement rates afforded under Medicare for teaching hospitals, a huge infusion of money, if the merger goes through. But would it over time restrict St. Vincent services from contraception, to in vitro fertilization, to abortion and more?The bishop of Arkansas, who has influence in the matter, says properly from his point of view that of course it would as far as St. Vincent is concerned There are secondary issues among the potentially blended workforce on employment policies related to sexual orientation and employee health insurance coverage of birth control pills and other services frowned upon by church doctrine.
Writes Daily Kos:
For many communities, a Catholic facility is already the only choice. And with the accelerating trend of hospital mergers and partnerships, policies forbidding contraception, abortion and sterilization are becoming the norm at formerly public hospitals. In cities around America, the result is growing confusion for physicians and greater risk for their patients.
Specifics are cited:
* An end to abortions at a Washington hospital that had provided them for decades.
* An end to sterilization as well as abortion at a Texas hospital.
* A physician wrote of his experience at another hospital:
[Raghavan's wife], a woman, also pregnant with twins, whose pregnancy was failing, threatening infection that could jeopardize her ability to have future children and perhaps her life. Distraught, she and her husband decided to terminate the pregnancy—only to learn the Catholic hospital would not perform the procedure
* From a New Hampshire hospital:
Physicians at the hospital, which had recently merged with a Catholic health care system, told her they could not end the miscarriage with a uterine evacuation—the standard procedure—because the fetus still had a heartbeat. She had no insurance and no way to get to another hospital, so a doctor gave her $400 and put her in a cab to the closest available hospital, about 80 miles away. "During that trip, which seemed endless, I was not only devastated but terrified," Prieskorn told Ms. "I knew that, if there were complications, I could lose my uterus—and maybe even my life."
* A widely publicized case in Arizona where a pregnant woman with heart failure sought treatment:
Physicians concluded that, if she continued with the pregnancy, her chances of mortality were "close to 100 percent." An administrator, Sister Margaret McBride, approved an abortion, citing a church directive allowing termination when the mother's life is at risk. Afterward, however, the local bishop, Thomas Olmsted, said the abortion had not been absolutely necessary. He excommunicated the nun and severed ties with the hospital, although the nun subsequently won reinstatement when she agreed to confess her sin to a priest.
In some places, the problem is acute because the merged institutions leave areas with no option but the religious-affiliated hospital with restricted services. That would't be the case if the UAMS-St. Vincent merger occurs in Little Rock, but it doesn't diminish the public policy question of having a publicly subsidized institution with restrictive health policies otherwise freely available by law.