Source: Ms., Title: “Women’s Health: A Casualty of Hospital Merger Mania,” Date: July/August 1998, Author: Christine Dinsmore
SSU Censored Researchers: Jennifer Mintz and Yuki Ishizaki
SSU Faculty Evaluators: Cindy Steams and Jeanette Koshar
Nationwide hospital mergers with Roman Catholic Church medical facilities are threatening women’s access to abortions, sterilization, birth control, in vitro fertilization, fetal tissue experimentation, and assisted suicide. In 1996, over 600 hospitals merged with Catholic institutions in 19 states. The merged partnerships extend from Portland, Maine to Oakland, California, and these mergers and partnerships with hospitals and health maintenance organizations (HMOs) are resulting in the impairment of reproductive health care rights across the nation.
Ms. gives the example of Kingston Hospital in Rhinebeck, New York. Kingston once performed about 100 abortions a year, but if merged with Benedictine Hospital, a Roman Catholic facility, it will provide the service for medical reasons only. No hospital in the community would provide birth control counseling or family planning services.
Collaborations between secular and Roman Catholic hospitals have made the Roman Catholic Church the largest private health care provider in the nation. Why would they want to join forces with secular hospitals? “The big money in the hospital comes when you have a closed system of doctors, HMOs, and hospitals all feeding each other in a closed loop,” writes Dinsmore.
Though activists object to partnerships between religious and secular hospitals that result in the ban of reproductive services, they are sometimes willing to accept lesser collaborations, such as joint ventures or affiliations, in which it’s more likely religious directives won’t be imposed. In response to community pressure, some health care agreements have resulted in independently-run women’s health clinics. Some activists, however, say it’s a lousy solution because separate women’s health clinics are often easier targets for antiabortion extremists. There are other drawbacks, says Frances Kissling, president of Catholics for a Free Choice: “Establishing a free-standing clinic as part of the elimination of services from an existing hospital is not a good compromise. Women should not have to go to more than one provider for their reproductive health services. They should be able to choose between a hospital and a clinic—the decision should not be made for them. In addition, most women deliver their babies in hospitals; it is important for those seeking tubal ligation to be able to have them immediately postpartum.”
“Another problem with separate clinics planned by hospitals,” says Kissling, “is that they often experience financial difficulties because women’s health care is not as profitable as a lot of other specialties.” Lastly, hospitals often say they’ll set up a separate women’s health clinic as part of a partnership agreement, and then simply don’t follow through on that part of the agreement, says Ms.
Besides the decrease in women’s health care services, other changes have occurred because of the mergers. According to Susan Fogel, legal director of the California Women’s Law Center, Sierra Nevada Hospital in Grass Valley, California, had been part of a sexual assault response team in which medical staff, domestic violence specialists, and members of the sheriff’s office worked together to make certain that the needs of both the sexual assault victim and law enforcement were met. Since the takeover, writes Dinsmore, Catholic Health Care West no longer participates in the program. It claims that it takes care of the victims in-house without coordination with its former team members.
Men are also affected by the mergers; when a hospital moves to free-standing clinics for women only, men seeking vasectomies will need to find that service elsewhere.
Health care workers, clergy, women’s groups, and HIV/AIDS advocates are creating coalitions to inform the public about possible future mergers. Currently there are few laws requiring community notification of impending non-profit partnerships, but activists are pressuring state lawmakers to pass protective legislation. California and New York are two states which have introduced bills for legislators to review. In response, a lobbying group called the New York Catholic Conference has made defeat of these bills “a priority.” Seeing them as “pressure to force Catholic entities to abandon their moral and ethical principles.” The stopping of these bills has become “second only to banning late-term abortions,” says Ms.
UPDATE BY AUTHOR CHRISTINE DINSMORE: “While abortion clinic violence grabs the headlines, the biggest threat to comprehensive reproductive services and a woman’s right to choose remains underreported. Nation-wide, Catholic hospitals are merging with secular hospitals in record numbers, resulting in communities losing access to abortion, birth control, tubal ligations, emergency contraception, and comprehensive HIV counseling.
“Although the entire community loses, poor woman are most affected. They depend on hospitals for reproductive health care when local physicians do not accept Medicaid. And if the community hospital doesn’t provide compre-hensive services, like adequate transportation, many poor women struggle to get to hospitals miles away from where they live. “Merger madness is not only wreaking havoc on communities’ medical services; it’s also producing the largest health care conglomerate. The Roman Catholic Church is now the largest private health care provider in the nation. With over $16 billion in assets, the Roman Catholic health care system wields tremendous power.
“But despite their Goliath foe, activists have succeeded in stopping some mergers. In New York’s Hudson Valley, activists and a Federal Trade Commission’s investigation into monopoly charges stopped a three-way hospital merger. In Baltimore, facing community protests, the secular hospital’s board of directors defeated its planned merger by one vote. In Batavia, New York, activists each paid $25 to become voting members of the hospital board. They created a majority voting block to control a proposed merger.
“In spite of successes, the Catholic’s ‘merger mania’ continues, according to Lois Uttley, director of Merger Watch. Her organization’s Web site (http://www.mergerwatch.org) provides updates on the threats to reproductive health care. “
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