The following comes from the November/December issue of Mother Jones magazine.

….Between 2001 and 2011, the number of American hospitals affiliated with the Catholic Church grew 16 percent, even as the number of public hospitals and secular nonprofit hospitals dropped 31 percent and 12 percent, respectively, according to MergerWatch, which tracks religious health care mergers. In 2012, Catholic hospitals and health care systems were involved in 24 mergers or acquisitions, according to Irving Levin Associates, a market research firm. Ten of the 25 largest nonprofit hospital systems in the country are Catholic, and Catholic hospitals care for 1 in 6 American patients. In at least eight states, 30 percent or more of patient admissions are at Catholic facilities.

Ten of the 25 largest nonprofit hospital systems in the country are Catholic, and Catholic hospitals care for 1 in 6 patients.

Catholic hospitals are required to follow health care directives handed down by the US Conference of Catholic Bishops—a group of celibate older men who have become increasingly conservative over the past few decades. (Recall the bishops’ ongoing showdown with the White House over Obamacare’s requirement that health insurance plans cover contraception.) The issues go far beyond abortion. The bishops’ directives restrict how doctors in Catholic hospitals may treat everything from miscarriages to terminal illness. How this treatment differs from that of secular hospitals is not always disclosed to patients.

“When you go into a hospital or an ER, you do not think that there’s a bishop between you and your doctor,” says Linda McCarthy, CEO of a Planned Parenthood branch in western Washington. In 2010, Peter Sartain, a prominent bishop recently enlisted by the church to crack down on nuns deemed too liberal, was appointed to the Seattle diocese. Not long afterward, he told the Catholic hospital in McCarthy’s area to stop performing lab work for Planned Parenthood that the hospital had handled for at least a decade, including tests unrelated to abortion, such as cholesterol screenings. McCarthy publicized the demand and the hospital backed off, for the time being.

“The Catholic bishops are seizing an opportunity to control the health care we all pay for, and they’re being wildly successful,” says Monica Harrington, the co-chair of Washington Women for Choice. A spate of proposed deals could leave Catholic facilities accounting for 50 percent of the state’s hospital admissions. “We could very well end up with three conservative bishops overseeing health care for 6 million people,” McCarthy says.

Abortion services are always quick to go when a Catholic hospital takes over, but the changes go much further. In many cases, doctors are prohibited from prescribing birth control, and hospital pharmacies won’t sell it. Doctors may even be told not to counsel patients about it. Catholic hospitals have been reluctant to offer emergency contraception to rape victims, and when they do, they first require a pregnancy test to ensure the woman was not pregnant before the assault. The bishops’ guidelines forbid tubal ligations and vasectomies. They also extend to end-of-life care: Catholic hospitals may ignore patients’ requests to be removed from feeding tubes or life support, even if those wishes are expressed in living wills. And many states allow religious hospitals to discriminate against gays and lesbians, both as employees and as patients.

Hospital mergers have let the bishops accomplish in practice what they haven’t been able to achieve through politics: making abortion and contraception harder to access.

Dr. Bruce Silva, an OB-GYN at Sierra Vista, remembers that during his hospital’s trial merger, church officials told doctors they could give chemotherapy to a pregnant woman with breast cancer, “even though you know it will kill the baby—but you can’t give her a termination before, because that would kill the baby directly.” Sierra Vista ultimately rejected the merger….

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