Federally Funding Incomplete Care

These days it seems like all I hear about are the twin crises of budget and healthcare, so I wasn’t surprised when one of my very first assignments this summer at LSRJ was to research religious hospitals and their funding. What did surprise me, however, was what I learned about the disparate standards of care between secular and religious healthcare facilities.


One out of every six patients in the U.S. is cared for in a Catholic hospital. In fact, the Catholic healthcare system is the largest private non-profit provider of healthcare in the nation – 70% of religiously affiliated hospitals identify as Catholic.  Because the Catholic healthcare system has significant medical responsibility for millions of Americans, the services they choose to provide or withhold can have a profound impact on the overall quality of care in the U.S. Additionally, religiously affiliated hospitals receive 50% of their funding from Medicare and Medicaid and also enjoy certain benefits like tax exempt status, low-cost financing through government bond programs, and in some areas, use of municipal buildings.


Because Catholic hospitals receive so much public funding and see so many patients, one might assume that the standard of care in a Catholic hospital is comparable to the standard of care in a secular hospital. Unfortunately, this assumption may not be true.


Some patients treated in Catholic hospitals – women in particular – may not be receiving reproductive healthcare considered basic and essential by secular medical facilities. That is because Catholic healthcare providers are governed by the Ethical and Religious Directives for Catholic Health Care Services, with which all Catholic health care providers are obligated to comply (Directive 5).


Under the Directives, Catholic hospitals are prohibited from providing contraception (Directive 52), sterilization (Directive 53), most infertility treatments (Directives 40, 41, 42), condom distribution for AIDS prevention (Directive 52 prohibits all contraception, regardless of the reason), or abortion services (Directive 45).  Directive 48 goes so far as to say no medical care that could be construed as abortion can be provided, even to a woman with an extra-uterine (ectopic) pregnancy.


It is also difficult to obtain emergency contraception in Catholic hospitals—even as treatment for rape or sexual assault. Despite the fact that it is expressly addressed in the Directives, the language of Directive 36 is unclear on when and under what circumstances EC can be provided:


Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.


Since emergency contraception is most effective in the first 72 hours, a healthcare provider’s refusal to provide comprehensive treatment can further traumatize survivors of rape and sexual assault by forcing them to leave the hospital and attempt to obtain EC elsewhere.


Catholic hospitals do provide a tremendous amount of care in rural and impoverished communities – indeed, they are often the only hospital in such communities. The question remains, however, whether funding institutions that refuse to provide the full spectrum of reproductive healthcare is really the best use of our scarce federal Medicaid and Medicare dollars.


-Megan Mullett


2 thoughts on “Federally Funding Incomplete Care

  1. Ah….yes… you are correct. But please remember that every woman and person has a CHOICE which hospital that they decide to go to.

  2. Unfortunately, Tara, that isn’t always true. While urban dwellers may have a choice of hospitals, many suburban and rural areas are served by only one hospital. Additionally, survivors of violent crime who are transported by emergency personal for medical evaluation are often not in a position to choose a hospital (if there is more than one in the vicinity).

    I feel like you may have missed the point of my post — even if every community had several hospitals to choose from, the fact remains that using federal tax dollars to fund facilities that do not provide the full spectrum of standard medical care is a questionable decision. Especially when those federal funds are creating two classes of people — those who can afford or have access to secular hospitals with comprehensive reproductive health care, and those who can’t. Comprehensive reproductive health care is a basic human right that should be available to all Americans.

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