With science deniers and Christofascists pushing for "religious liberty laws" that apply to businesses, not just individuals, the argument takes on a whole new dimension when you realize that eight of the largest health care systems in America are owned by the Catholic Church.. As I have argued before, business entities do not merit conscience clauses or religious belief exemptions that allow them to flout general laws and, worse yet, discriminate against citizens. The rule ought to be that they either comply with all applicable laws or lose their tax-exempt status. A piece in Salon looks at the threat posed by the Catholic Church's control of major health care systems. Here are highlights:
Angela Valavanis had already had one bad encounter with the Catholic health care system when St. Francis Hospital, the hospital in Evanston, Ill., where she delivered her second baby, refused to allow her OB/GYN to tie her tubes because of Catholic restrictions on the procedure. When she went to her doctor’s office for a check-up after the birth and asked about going back on the Pill, since she hadn’t gotten the sterilization she wanted, she got another shock: “My doctor told me that she couldn’t prescribe birth control because she had sold her practice to a Catholic health system,” said Angela. “My mouth dropped open. I was so confused to hear those words coming out of the mouth of an OB/GYN.”
An OB/GYN who can’t prescribe birth control? It’s not some bad joke. It could be a reality if your doctor’s practice is purchased by a Catholic health system that then imposes the Ethical & Religious Directives for Catholic Health Care Services, a set of rules created by the U.S. Bishop’s Conference that prohibits doctors from doing everything from prescribing the Pill to performing sterilizations or abortions.
And Angela’s experience may be just the tip of the iceberg. Driven by health-care economics and incentives in the Affordable Care Act, health systems, which are a collection of hospitals and ancillary services, are acquiring physician practices at an unprecedented rate. The percentage of doctors who were employees of health systems increased from 20 percent to 26 percent between 2012 and 2013 alone; more than 40 percent of primary care doctors like OB/GYNs are now employed by health systems directly, and experts don’t see the trend slowing.
And with Catholic hospital systems accounting for eight of the 10 of the largest nonprofit health systems in the U.S., these hospitals are poised to become major owners of doctors’ offices, which could severely impede access to contraceptives if doctors are forced to follow the Directives. “The more we see these Catholic systems buying up these practices, the more we are going to see what Angela saw,” predicted Lorie Chaiten, director of the Illinois ACLU’s Reproductive Rights Project, who notes that such refusals are legal under Illinois’ Health Care Right of Conscience Act.
[F]or some women, changing doctors may not be an option. Health insurers are becoming increasingly restrictive about which hospitals and doctors a patient is allowed to use and may charge a steep penalty for going out of the network of preferred providers. Smaller towns and rural areas may not have a large selection of OB/GYNs. The ACLU is backing a measure in the Illinois Legislature that would require health systems to tell patients beforehand what services they don’t provide and where they can get them. Chaiten also encourages women who have been denied reproductive health services for religious reason to report it to the ACLU, which is tracking this trend.
Ironically, Angela’s experience with her OB/GYN wasn’t her last run-in with Catholic health care. After she was refused a tubal ligation and a prescription for birth control, Angela’s husband decided to get a vasectomy. His doctor, who was also part of the Catholic system, said his practice couldn’t do the procedure or make a referral. “The whole situation is so unbelievable to me. I had no idea these limitations occurred,” she says. “When I tell my friends about it, they say it’s medieval. We have to worry that if they keep buying up all these practices, it will get harder and harder to find someone who can prescribe birth control.”