(Editor's note: The following article was published at modernhealthcare.com and as a guest commentary in the Jan. 27 issue of Modern Healthcare.)
By Lloyd Dean, Michael Hunn, Robert Issai and Deborah Proctor
We were surprised and disappointed as to how Modern Healthcare chose to cover the recent report from the American Civil Liberties Union and MergerWatch ("Catholic systems' growth threatens women's care, report says," ModernHealthcare.com).
Our discomfort relates to the fact that the report relies on fear-provoking, inflammatory hypotheticals, misrepresentations and outright misstatements to support its contention that Catholic hospitals' religious values preclude them from providing effective medical care to women, and that mergers between Catholic and non-Catholic hospitals are reducing the availability of abortion and rape victims' access to drugs such as the "morning-after pill." These claims are not supported by one credible study and are contradicted by the facts.
First, Catholic hospitals operate in one of the most highly regulated sectors of the economy. For example, since 1973, California's Health and Safety Code has required hospitals to provide patients with emergency medical treatment, and the federal government has had a similar law since 1986, the Emergency Medical Treatment and Labor Act. Under these laws, if a hospital cannot treat an emergency patient, the hospital is required to stabilize the patient and transfer her to a facility that can.
During the more than 40 years these statutes have been in existence, neither the state nor federal government has identified one instance in which a pregnant woman received inappropriate emergency treatment at a Catholic hospital. Moreover, an extensive, but preliminary report by Washington state's Healthcare Research Group on access to reproductive services and assisted-suicide recently concluded, "Those services assessed do not appear to suggest that communities predominantly served by religious hospitals are experiencing barriers to care."
Second, there are 54 Catholic-affiliated hospitals in California. They represent about 16.5 percent of all California hospitals, more than 20 percent of emergency room visits and 21.5 percent of births. Despite their substantial presence, Catholic hospitals have not diminished the availability of abortion in California. According to the Guttmacher Institute, California has an abortion rate per 1,000 women ages 15-44 well above the national average, and performs more abortions than any other state. Only 1 percent of California women live in counties that have no abortion provider.
Third, more than 15 California Catholic-affiliated hospitals are designated rape trauma centers, and/or sexual assault response team sites. Despite the ACLU's claims to the contrary, Catholic hospitals provide emergency contraception when treating rape victims. Moreover, Catholic moral principles do not preclude them from doing so.
Fourth, Catholic religious directives are far more nuanced than the ACLU and MergerWatch report allege. For example, they require physicians to provide all reasonable information about the essential nature of proposed treatments, their risks, side effects, consequences and cost, including no treatment at all. They also provide for medical interventions that address serious pathological conditions that cannot be postponed, even if they result in the foreseen but unintended death of a fetus.
Catholic hospitals' values and priorities have produced valuable results for their patients. An independent 2010 analysis of 255 health systems ("Differences in Health System Quality Performance by Ownership", conducted by Truven Health Analytics) revealed "significant differences in performance exist between classes of ownership." The analysis found: "Catholic and other church-owned systems are significantly more likely to provide higher-quality performance and efficiency to the communities served than investor-owned systems. Catholic health systems are also significantly more likely to provide higher-quality performance to the communities served than secular not-for-profit health and investor-owned systems."
In June 2013, a second independent analysis by Truven largely confirmed these findings. The studies do not explain why Catholic hospitals generally, but not always, outperform other hospital groups — not-for-profit, for-profit, government. But the answer might be found in the very religious values the ACLU and MergerWatch stridently decry: Catholic hospitals' self-understanding as ministries animated by a deep commitment to human dignity, justice, the common good, service to the most vulnerable and stewardship, might explain their superior performance as measured by the studies' metrics related to quality, patient satisfaction and efficiency.
Knowing these facts and attracted by these values, most patients are grateful for the presence of a Catholic hospital in their community.
Lloyd Dean is president and chief executive of Dignity Health, San Francisco; Michael Hunn is senior vice president and chief executive of Providence Health & Services, California region; Robert Issai is president and chief executive of Daughters of Charity Health System, Los Altos Hills, Calif.; and Deborah Proctor is president and chief executive of St. Joseph Health, Irvine, Calif.
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