Keeping Catholic Hospitals True to Their Identity: A Winning Health Care Proposal

A friend just got a job in a Catholic hospital. She loves the work, and I hear with delight about the employee training program and the mission of top-flight care in a Catholic setting.

She is a receptionist, and hospital leaders know values must be conveyed by all the staff, from the first person you meet to the professional staff who hold lives in their hands.

Values that emphasize the sacredness of every person, rich or poor, coming into life or leaving it, are paramount in Catholic hospitals and right now the U.S. bishops are working hard to make sure these values will still exist under health care reform.

Catholic health care encompasses more than 600 facilities; the ministry costs about $6.7 billion annually. Yet, although Catholic hospitals are a major force, their unique nature could be threatened if the health care reform bills dismiss concerns of the bishops.

The U.S. bishops do not want an expansion of abortion and urge that the policy of the Hyde Amendment be preserved. The Hyde Amendment, first passed in 1976, precludes federal money from being used to pay for elective abortions or plans which provide coverage for them. This already is policy for several major federal health programs. The underlying principle: health care reform should not force anybody to pay for another’s abortion.

The bishops want conscience protection for institutions and individuals. Among other things, they would like to see the language of the Weldon Amendment incorporated into health care reform. Weldon, passed in 2004, prevents government bodies from discriminating against hospitals and other health care providers that do not perform, refer for or pay for abortions. Health care facilities and personnel have the right to provide care according to a value system that respects each human life. Language from the Weldon Amendment is now in the House health care reform bill and needs to be retained in final legislation.

The bishops as employers are not forced by federal law to pay for health plans that cover such services as abortion and sterilization and they want to retain that right. The church does not believe these are morally acceptable and it does violence to the church to force it as an employer to pay for them. This is a matter of conscience, of being true to one’s identity.

Charity care is part of any Catholic hospital but these hospitals also have to follow sound business practices. Emergency rooms must serve both insured and uninsured. The bills before Congress preserve current law that prevents legal immigrants from accessing federal-health care programs, such as Medicaid, for five years, even though they work, pay taxes, and soon will be citizens. They also prevent undocumented persons from buying into a newly-created health-care exchange, forcing them to stay uninsured and dependent on emergency room care. This is bad public policy, since the costs of their care would be borne by taxpayers. Under these rules, a hospital is forced to serve the sick, which is good, but can’t be reimbursed by insurance because some patients are denied entry into the government health care system even when they can afford to pay for it.

Catholic Charities provides about $3.5 billion annually in services. Much of it goes to people who can’t make ends meet. The health care reform proposals are burdensome at best. A family of four earning $29,500 would have to pay four percent of its income for health insurance and would have inadequate protection on high deductibles and co-payments. That’s almost $2,000 annually. Out-of-pocket expenses for health care could be near twenty percent of their income.

My friend feels she’s glimpsing heaven, in a place that respects people, rich or poor, coming into or leaving life on earth. She is part of something important to both church and society. Millions who have been patients in Catholic hospitals can attest to that! If Congress works with the bishops to uphold this gift to our nation, everybody wins.

Conscience Protection Key for Health Care Reform

Conscience protection is a key issue in health care reform. The bishops want protection for Catholic and other institutions, especially health care institutions, so they can to be true to their vision, and for all health care personnel so they can be true to their conscience.

Today we often see the rights of institutions challenged. The most obvious concern is the right of hospitals not to perform abortions. The Weldon Amendment, a rider to the annual Health and Human Services funding bill, protects hospitals that do not provide, refer for or pay for abortions. Yet even with its existence this right of conscience is threatened when pro-abortion groups organize campaigns against hospital mergers in which a Catholic hospital assumes responsibility for a struggling hospital that is not Catholic. Some groups fight such mergers unless the “right” to an abortion can be guaranteed there or close by. Sometimes, they make mergers fall through, sad proof that some would rather risk seeing all health care denied, from heart catheterizations to hip replacements to cancer treatment, in order to keep abortion in the neighborhood.

Any health care reform bill needs to have conscience protections for institutions that provide and purchase health care. The Catholic Church, with more than 600 health care institutions serving millions annually, is a major health care provider in the United States. The quality of care in these facilities is proven time and time again. Conscience protection for them benefits not just Catholic hospitals, but the nation’s entire health care system and the patients it serves.

Conscience protection for individuals also needs to be guaranteed. Wherever they work, those who find abortion morally repugnant should not have to participate in it. You don’t have to be a moral theologian to feel abortion is wrong. Some things are instinctive, and some are enshrined in the Hippocratic Oath that has shaped the idea of medicine as a healing profession. No medical personnel should be forced to take another human being’s life.

Today it can be hard to stand up against peers and supervisors; if an individual feels his or her job is on the line, the pressure can be enormous. A case in point: In Ohio, last September 15, according to an Associated Press news report, Dr. Carmelita Bautista was pressed into service by a prison execution team to help find a vein so a lethal injection could be administered. This is something medical ethicists frown upon and the American Medical Association bans. Despite this, Dr. Bautista apparently felt she had to agree to the casual request. Apparently she felt uneasy, noting later that she’d never done anything like that because, she said, “we are supposed to help people who are sick.” Nevertheless, she did what she was asked and tried - unsuccessfully - to help. It was a casual request, to just find a vein, and she wasn’t sure she was really assisting at an execution, but as she drew closer to the death house she felt frightened.

Who else might be casually asked to violate conscience just a little - a medical student, a nurse, someone else low on the totem pole? Such people, no matter where they work, need to know they have the protection of law, and it should be written into the health reform bill.

Resistance to writing in such language makes one pause. Do government leaders fear we’ll be overrun by citizens with consciences?

The battle over conscience rights extends into other areas. Should a doctor be forced to prescribe drugs he objects to, such as those that disrupt a healthy reproductive system? Should pharmacists be forced to fill a prescription for what they know may work by causing an abortion? We’re talking about professionals, here, not vending machines. Forcing someone to violate his or her conscience is an act of violence no civilized society should tolerate.

The poet John Donne said that “no man is an island,” that “any man’s death diminishes me.” Conversely, one might say that “everyone’s living by conscience enhances me,” for we are not isolated individuals but live together in society. Defense of the right to live by one’s conscience, be it an individual’s or an institution’s, helps guarantee access to quality health care reform for all. The defense of conscience rights needs to be written into the health care reform bill.
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