The gusty winds of healthcare reform have recently swept through my city, Louisville KY. Similar to what is happening across the US, hospitals in Louisville seek consolidation. Strength be in numbers and in control of patients.
The problem with merging University of Louisville Hospital (public), Jewish Hospital and St Mary’s and Elizabeth Hospital (both private) was that ultimate control of the merged system would have rested in the Denver-based Catholic Health Initiative.
Of course, you can probably guess the issue:
In regards to women’s reproductive health, Catholic doctrine severely impacts medical-decision making. It’s not just banning abortion; common therapies like prescribing oral contraceptives and tubal ligation would be prohibited. An especially scary scenario here involves the management of ectopic pregnancy, where abortion of the (ultimately inviable) fetus is required to save the life of the mother. Technically, Catholic doctrine prohibits the only acceptable therapy.
Merger proponents argued that the benefits of the merger–financially propping up University Hospital, which serves the indigent and provides medical education–would ultimately serve the community as a whole. Proponents cite arrangements for reproductive services at a nearby hospital. Basically, they argue that the benefits of the merger outweigh the costs. One proponent recently told me in the doctors’ lounge that University Hospital did only 27 tubal ligations last year. “Can’t we somehow work around this small number, for the greater good.”
So…
Is the greater good worth giving religious doctrine veto power in the medical care of women?
The debate in town was both intense and wide-reaching, even making mention in the WSJ. After a legal opinion rendered the merger a public matter, as University Hospital was deemed a public institution, the decision went to the Governor. He stewed. And waited. He sought opinions. The anticipation mounted.
Then the decision: No to the merger.
Thank goodness.
Even though I see and understand the greater good, and I think Catholics do a lot of good, the price was simply too high. Spirituality is one thing; I believe in the spirit of human goodness. Spirituality entwines itself with the human heart.
But I also believe in the religious freedoms set out by our founding fathers. America has this idea right.
The more I learn about our framers, the more impressed I am with their ‘enlightenment.’
JMM
(Full Disclosure: I was raised Catholic. I like a lot about Catholicism.)
Allison says
I’m impressed with your governor’s thoroughness and thoughtfulness in making the decision not to approve the merger. It would have set terrible precedent to allow a public health agency to become the property of a private religious agency. Even worse would have been the outcome that a religious agency would be free to restrict health care based on doctrine and not science. Does Kentucky not have “sunshine” laws that require such discussions to be held publicly? I was surprised to read that negotiations had been held in secret sessions. Despite the loss of revenue, or cost sharing, or economies of scale or whatever that were to be achieved by the merger, it was bad public policy.
Dr John says
Not sure about ‘sunshine’ laws. That’s outside my scope.
Restricting sounds like a bad word when it comes to providing health care. Doesn’t it?
Vincent Wilhelm says
I was also raised Catholic and think Catholics do a lot of good stuff, but I agree with you on this 100%.
Dr John says
Thanks
Betsy says
Kudos to your Governor, and congrats to the women of Louisville for avoiding the loss their healthcare services (all services). You don’t know what you got till it’s gone…as was the case a few years back in my area in Upstate NY. The more powerful Catholic hospital took over the struggling public one up the hill. The Catholic hospital was a great place to have a baby (I had my son there 23 years ago), but if I wanted a tubal ligation, I would have had to go somewhere else (St. Elsewhere?!?)
I was raised Catholic also, but the black and white (with no gray areas) doctrine is ludicrous for people who have to make some hard choices.
Dr John says
Thanks for saying Betsy.