Catholic health care networks now make up five of the top ten health care networks by market size. As a consequence, corporate executives and HR professionals need to understand the ramifications of religiously-inspired health care restrictions on their employees. Unfortunately, many employers don’t understand the full impact of how doctrine-based restrictions negatively impact patient care and add to overall health care costs.
If you are an employer in a state, like Washington or Oregon, with a high concentration of Catholic health care facilities, here’s what you need to know:
1) Catholic health care has evolved into something substantially different from the evidence-based care delivered through secular health care facilities.
2) Catholic health care facilities are required to adhere to the Ethical and Religious Directives for Catholic Health Care, a 43-page document that lays out the rules for how care can be delivered in Catholic-affiliated facilities. According to the Directives and Catholic doctrine, contraception, vasectomies, tubal ligation, and abortion under any circumstances are intrinsically evil and thus expressly forbidden, even in situations where a patient’s life or health may be at risk.
3) In recent years, the Vatican has ordered a crackdown on more progressive nuns who have traditionally run Catholic health care facilities. The Vatican and the bishops are unhappy that nuns have quietly provided contraception and have not been harsh critics of same-sex marriages.
4) The bishops are asserting their will in ways that undermine patient care, especially for reproductive-age patients and patients facing decisions related to end-of-life care.
5) The Catholic bishops have demonstrated they are willing to go to new lengths to undermine patient health. In Washington and Oregon, they have asked local hospitals and labs, which are supported with taxpayer dollars, to no longer run lab tests for Planned Parenthood patients.
6) Hospitals that restrict services for religious reasons are not required to disclose the restrictions upfront, and this can and will end up costing more and burdening your employees. In 2012, a Seattle woman who chose Swedish Hospital (which recently became part of Providence) specifically because of its long-standing reputation for excellence in maternal care, ended up being denied an abortion, even after doctors told her she was miscarrying. (This patient story was recently written up in Seattle’s The Stranger.)
Similarly, patients who deliver in Catholic hospitals and who want a tubal ligation at the time of delivery, are typically not told upfront that since tubal ligations are not allowed, they must go through a separate, additional surgery at a different nonCatholic facility.
7) Patients who present with an ectopic pregnancy, which is a life-threatening condition, at Catholic facilities are typically denied drugs to end the nonviable pregnancy, and instead are subjected to surgery (the removal of a Fallopian tube) that permanently damages patient fertility. This is because of specific Church policy that abortion can never “target” a fetus or embryo, even when a woman’s life is at risk.
The reason HR managers and directors are often not aware of these restrictions is because the Bishops work hard to minimize “scandal.” Oftentimes, hospital administrators claim that the religious restrictions allow room for interpretation while talking externally, while behind the scenes, they require strict adherence to the Directives.
If you are a senior corporate executive or HR professional, here’s what you need to do to protect your employees:
1) Do not sign any agreements that would allow a provider that restricts care for religious reasons to be the exclusive provider for your employees’ health care needs.
2) Insist on disclosure as to specifically what services health care providers offer related to reproductive services. Make sure very specifically that any provider offering ob-gyn care offers contraception, tubal ligation, and vasectomies and abortion services consistent with state law.
3) Ask your providers to disclose any restrictions that might be in place related to end-of-life directives. A good question to ask: Will advance directives will be honored if they are consistent with state and federal law?
4) Will your facilities honor all legal marriages, including those between same-sex couples. (In Washington, where same-sex marriage is legal, a same-sex couple was recently told that the Catholic hospital would not recognize their marriage as a matter of “policy.”)
If you have any other questions or concerns or would like more information, please contact the editor at firstname.lastname@example.org.