Wendy Norris, a freelance reporter and editor in Denver, writes regularly on assignment for RH Reality Check.
The justifiable anger at the U.S. Conference of Catholic
Bishops for lobbying on the Stupak-Pitts amendment overshadows what is possibly
the bigger motive for the Vatican: the billions of dollars at stake for the
The scale of the church’s involvement in the rapidly growing
$2.5 trillion dollar American health care industry is staggering.
What the Stupak-Pitts amendment does for the Catholic health
care system is omit a competitive advantage secular and other
religiously-affiliated hospitals without doctrinal restrictions can use to
simultaneously market their services to both the expected influx of newly
insured patients and the outpatient medical professionals who will treat them.
By restricting insurance coverage of women’s reproductive
health care, the competitive barriers faced by Catholic institutions will be
eliminated — provided the amendment is not stripped out of the final bill that
emerges from House-Senate health care reform conference committee. Which is why
pro-choice advocates should expect nothing short of a full-frontal attack by
the Vatican on conservative Senators.
And in the case of an industry that accounts for 18 percent
of the gross domestic product and is expected to double in less than 10 years,
it’s absolutely critical to follow the money.
One in six patients are cared for in 624 Catholic
hospitals scattered throughout the U.S. in 2006, according to the Catholic
Health Association. The church also operates more than 800 post-acute care,
senior living and skilled nursing centers across the nation. All told, $84.6
billion was spent on Catholic church-affiliated care.
The Denver-based Catholic Health Initiatives is now the
largest of the church’s hospital systems in the country with 78 hospitals and
40 long-term care facilities in 20 states and operating revenues exceeding
$9.6 billion ranking it sixth among all for-profit and charity health care
Now consider that there are 60 some Catholic-affiliated
hospital systems in all 50 states — representing 13 percent of the nation’s
entire in-patient health care system. That’s easily tens of billions of dollars
flowing through the business arm of the Catholic church that continues to grow
through mergers with private and other religiously-affiliated hospitals.
Congressional health insurance reforms promise the prospect
of 36 million uninsured Americans — who are currently self-rationing care,
paying on sliding fee scales, or not paying at all — flowing into hospitals,
clinics and outpatient facilities via subsidized insurance, mandated policies
and more affordable options in the proposed insurance exchange.
Conservatively, those newly insured people will not only add
millions of dollars more to hospital coffers in the short term but the
potential for trillions in billable services over their lifetimes.
So why would the bishops risk the House health reform bill
collapsing under the weight of a bitter abortion debate? It appears to be a
fairly brazen attempt to kneecap their health care industry competitors while
knowing the president’s top domestic agenda would be passed in some way, shape
Catholic institutions are uniquely bound by religious
directives on care, effectively eliminating key reproductive health and
end-of-life treatment that other institutions will provide to patients and bill
to their insurance carriers.
Add those restrictions and compound it with two simple
facts: 73 percent of the now uninsured are of reproductive age and the leading
cause of death among people aged 15-44 is accidents.
In essence, the people most likely to benefit from the
proposed public option and insurance exchange will undoubtedly be seeking the
type of care Catholic hospitals refuse to provide as a matter of religious
principle. And these prospective patients are young and will conceivably need
care for many decades to come.
For the business arm of the Catholic church it’s a
theological and economic two-fer.
The bishops can extract abortion care from the private
insurance benefits of millions of American women that are federally subsidized
ten ways to Sunday (with the blessing of conservative lawmakers’ corporate welfare
earmarks) and they level the competitive playing field without having to revise
its medical doctrine to modern standards of care.
Analyzing the bishops’ lobbying efforts from a cold,
calculating green eyeshade perspective adds a very different dimension to their
motives that may help spur secular business interests to protect both a woman’s
right to choose and their own bottom line.
The pro-choice community should raise holy hell with
lawmakers for passing the discriminatory Stupak-Pitts amendment. But while
you’re grabbing your pitchfork look to some new allies in unlikely places where
the password is money.