Biblical Medicine? How Religious Corporations Are Gobbling Up Healthcare Facilities
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When it comes to matters of individual conscience, Washington State voters have a don’t-mess-with-us attitude that makes Texans look like cattle—and it goes way back.
In 2012 Washington voters flexed their muscle by legalizing recreational marijuana use and marriage for same-sex couples. In 2008, death with dignity passed some counties by as much as 75 percent. In 2006, Washington lawmakers outlawed discrimination based on sexual orientation and gender identity. In 1991 a citizen initiative established that “every individual has the fundamental right to choose or refuse birth control” and “every woman has the fundamental right to choose or refuse abortion.” It also guaranteed an absolute right to privacy around mental health and reproductive issues for teens aged 13 and up. Washington state’s constitution includes an Equal Rights Amendment and (from the get-go) a stronger wall of separation between church and state than the U.S. Constitution.
In other words, west of Moscow, Idaho, and north of Portland, any bishops who want to control what they think of as their sacramental turf --birth, coming of age, sex, marriage, trippy transcendent experiences, and death—haven’t got a chance in hell at the ballot box. Washington even has extended statutes of limitations on child sex abuse—something Archbishop Timothy Dolan successfully fended off in New York and Pennsylvania. The Archdiocese of Spokane declared bankruptcy.
But the Vatican hasn’t survived for 1,500 years by being stupid. And as my devout family members like to say, “Where God closes a door, he opens a window.” The window the bishops found open in Washington takes the form of independent hospitals with financial problems.
Thanks to changes in healthcare delivery, more and more independent hospitals are being forced to merge with large healthcare corporations. The pressures include expensive equipment, complex electronic record keeping technologies, and an Obamacare-driven push for greater administrative efficiency. Rather like mom-and-pop hardware stores that survived by becoming Ace franchisees with standardized, streamlined supply and distribution systems, independent health facilities are surviving through acquisitions and mergers with other hospitals and healthcare corporations.
Of the largest healthcare corporations in the country, five of six are administered by the Catholic Church including the famously conservative Catholic Health Initiatives which operates the Franciscan brand and has $15 billion in assets. By the end of 2013, if all proposed mergers go through, 45 percent of Washington hospital beds will be religiously affiliated. In 10 counties, 100 percent of hospital facilities will be accountable to religious corporations, which are rapidly buying up outpatient clinics, laboratories and physician practices as well.
New partnerships can be viewed as opportunities for Catholic healthcare institutions and services to witness to their religious and ethical commitments and so influence the healing profession. . . . For example, new partnerships can help to implement the Church’s social teaching.
Here is the diabolical stroke of genius. In any merger between a secular and Catholic care system, fiscal health comes with a poison pill. One condition of the merger is that the whole system becomes subject to a set of theological agreements call the “ Ethical and Religious Directives for Catholic Health Care Services” or ERDs. Rather than care being dictated by medical science and patient preference, a set of religious doctrines place restrictions on what treatment options can be offered to (or even discussed with) patients.
Under these agreements, the patient-doctor relationship becomes a patient-doctor-church relationship: “The Church’s moral teaching on healthcare nurtures a truly interpersonal professional-patient relationship. This professional-patient relationship is never separated, then, from the Catholic identity of the healthcare institution.” Furthermore providers who work in these systems are required to sign binding contractual agreements to adhere to the religious directives, whether or not they are Catholic: “Catholic healthcare services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives . . . .”