ACLU Criticizes Catholic Health Systems
A scathing report has taken Catholic hospital operators to task for their dramatic market growth over the past decade, blaming them for curtailing reproductive services for women and claiming they stint on charity care for indigent patients.
The report, “Miscarriage of Medicine: The Growth of Catholic Hospitals and the Threat to Reproductive Health Care,” was issued jointly by the American Civil Liberties Union and the advocacy group MergerWatch. It claims that the number of Catholic-affiliated hospitals has grown 16% between 2001 and 2011, while all other not-for-profit hospitals declined in numbers.
It noted that Catholic hospitals had mostly standalone facilities until the mid-1990s, at which point they began to affiliate and merge with other facilities in order to gain a market advantage in order to better negotiate with insurers.
As a result, 10 of the 25 largest hospital systems operating in the U.S. are now Catholic-affiliated. St. Louis-based Ascension Health is the largest, with 69 facilities and more than 13,700 hospital beds. San Francisco-based Dignity Health is the largest Catholic-affiliated operator in California, fourth largest among all the large Catholic systems, and tenth-largest healthcare system in the nation, with 36 hospitals and 7,321 beds.
Overall, Catholic-affiliated hospitals operated 76,517 inpatient beds nationwide in 2011, nearly 10,000 more than in 2001. Altogether, Catholic-affiliated hospital ownership increased to 381 hospitals in 2011 versus 329 in 2001, according to the report.
“In short, our report reveals how Catholic hospitals have left far behind their humble beginnings as facilities established by religious orders to serve the faithful and the poor,” said Lois Uttley, director of MergerWatch and co-author of the report. “These facilities have organized into large systems that are aggressively expanding to capture greater market share, while relying on public funding and using religious doctrine to compromise women’s health.”
In one example, the study cited a 2010 incident where a woman who had been 15 weeks pregnant miscarried one of her twins and sought treatment at Sierra Vista Regional Health Center in Arizona. Despite a hospital physician's recommendation to terminate the pregnancy of the remaining twin, the woman was sent by ambulance to another facility more than 80 miles away in order to perform the procedure due to Catholic-oriented directives prohibiting abortions. Sierra Vista's board of directors has since voted to end its affiliation with Carondelet Health Network, citing pressure from staff physicians and a complaint filed with the Arizona Attorney General's office by the National Women's Law Center.
In California, control of Catholic-affiliated hospitals has remained fairly static over the past decade. Dignity, which formerly operated under the name Catholic Healthcare West, operates 32 hospitals in California, compared to 35 in 2001, primarily due to mergers or closures of existing facilities. Saint Agnes Medical Center in Fresno, affiliated with the Michigan-based Trinity Health system, is the only Catholic-affiliated hospital in the state not operated by Dignity.
In addition to what it claims is curtailing of women's reproductive services at Catholic-affiliated hospitals, the report also claims Catholic-affiliated hospitals have been relatively miserly when it comes to providing charity care. Altogether, the report said that Catholic hospitals spent 2.8% of total patient revenue on charity care in 2011, versus the nationwide average of 2.9%. By comparison, public hospitals spent 5.6% of total patient revenue on charity care.
The report recommended that acquisitions of hospitals by Catholic-affiliated systems receive greater scrutiny, patients are given more information regarding their care choices when choosing a Catholic hospital for services, and federal laws regarding emergency care be better enforced.
