The Insidious Threat of the Catholic Church Owning Your Doctor

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.”

And lest we forget, the Roman Catholic Church is exceedingly anti-gay and one has to wonder who married days and the families will fare under the Medieval world view of the U.S. Catholic Bishops.

A Broken Health Care System

We have not talked about the nation's broken health care system lately, but a recent story out of Virginia again highlights a system that seems operated more for the benefit of insurance companies than for meeting the needs of sick and/or injured citizens. This story deals with an attempt by the Virginia General Assembly - hardly the world's most august legislative body when it comes to giving a damn about average Virginia residents - to require insurance coverage to include artificial limbs. But wait, according to the insurance lobby, such limbs are luxury items and not necessary treatment. Tell that to someone who has lost a leg or an arm. Rather than offend the powerful insurance lobby, the General Assembly appears headed to capitulation - artificial limbs will only be an offered option, assuming the policy purchaser has the where with all to ask about the coverage. Here are some highlights from PR Newswire:

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Virginia's insurance lobby continues to fight hard against passage of a bill that would require insurance companies to offer coverage for artificial limbs as an option to their policyholders. The insurance industry wants to continue treating prosthetic limbs as a medical luxury while amputees demand that the costs be treated the same as other major medical expenses. . . . On Thursday in Virginia's General Assembly, Senator Fred Quayle [from Hampton Roads], one of the bill's (SB 1116) supporters recently amended the proposed legislation's language, changing it from a "required benefit" to an "offered benefit."

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"For the past two years, amputees in Virginia have been fighting for passage of a bill that requires health insurers to cover the cost of prosthetic devices and components," says Charles Coulter, an amputee activist. "There's no reason that an amputation and the requisite follow-up care, including an artificial limb, aren't covered by health insurance like every other disease, such as cancer or a heart attack. By denying amputees coverage for artificial limbs, we're denying them the opportunity to return to the life they once knew, and forcing many to quit their jobs in order to qualify for Medicaid, which does cover prosthetic devices and care."

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"The reality today is that no one ever expects to lose a limb, and as a result, few people rarely think about how to pay for a prosthesis or even know what kind of coverage they have through their insurance policy, until they need a prosthesis," Coulter said. "To deny them coverage for an artificial limb and force them to a wheelchair denies them the opportunity to reclaim the life they once knew, and that's not right."

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As always, Virginia is for sale to the lobbyists and the rights and true needs of average citizens get thrown on the trash heap. And for those who do not know, to qualify for Medicaid coverage, one must have first more or less made them self indigent and liquidated all of their assets.