It seems another fight is brewing over Catholic hospitals and reproductive health care - this time in Maryland. Adventist Healthcare, based in Rockville, MD, is challenging the recommendation of Maryland Health Care Commission chair Marilyn Moon and with it a Catholic hospital's request to build a multi-million dollar hospital in the state.
According to Adventist, Moon's findings were unsubstantiated and flawed - in part as they relate to reproductive health care availability in the state. Holy Cross Hospital's newest proposed center would not offer the range of reproductive health care women in the community need - including fertility treatments, abortion and hormonal contraception.
The Washington Post reports that, for "two years, the two health-care giants have waged a costly and intense competition for state approval of a new hospital in Montgomery's fastest-growing region." Adventist wants to build a hospital a few miles to the north of where Holy Cross has proposed its new center. But Moon says that Holy Cross' proposal, to build on the Germantown campus of Montgomery College, was superior. She also noted that Holy Cross has "a track record that is equal to or better than that of the Adventist hospitals 'with respect to quality of care, community benefits, and efficient and effective management.'"
In response to Moon's recommendations, Adventist filed a 105-page document of exceptions today with the Maryland Health Care Commission, asking them to "reopen the comparative review of upcounty hospital projects because...the recommended decision..." is flawed.
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In direct response to Adventist's concerns that Holy Cross does not provide critical reproductive health care services to women, Moon wrote, "I do not find that approval . . . would have a substantial negative impact on the availability or accessibility of the services that [Holy Cross Hospital-Germantown] will not provide, because it will be adhering to the doctrines of the Roman Catholic Church."
A host of local and national women's groups had raised concerns about Holy Cross' refusal to provide many health care services the women of Maryland need including the Maryland Coalition for Sexual Assault, Planned Parenthood of Metropolitan Washington, The MergerWatch Project, and the National Women's Law Center. Citing those groups letters and Moon's recommendation, Adventist HealthCare writes:
"Having identified the importance of this issue and having made a specific finding that there will be no substantive negative impact of approving [HCH-G], the Recommended Decisions should state the evidence on which this conclusion is based."
It's an important question for women's health advocates as well. As Catholic hospitals expand and in the face of pressure from the Catholic Church hierarchy not to perform life-saving abortions on patients - even in emergency situations - just how safe is it for women when states allow Catholic hospitals to continue expanding into various communities? And do Catholic hospitals truly meet the needs of the communities in which they reside if they are not providing all methods of contraception, fertility treaments and other services?
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At the very least, a measurable impact of the lack of certain services at Catholic hospitals upon the public's health should be shared when a decision like this is made. As Rachel Walden has written in the past, however, this is far from a new issue. Yet it's important to realize, she says, that "simply choosing another hospital" is not always an easy option:
To be perfectly clear, I understand that private hospitals may have every right to perform only procedures that do not conflict with their religious missions, as patients are free to go elsewhere. I worry, however, about those women whose insurance dictates a provider list at hospitals that do not perform the procedures they need – those women are only free to choose another provider to the extent that they are able to pay out-of-network charges and another provider is available within an accessible distance and time frame.
She also reminds us that if, for example, a woman undergoes a cesarean section, she may very well wish to have a tubal ligation done at the same time. That, however, is not possible in a Catholic hospital. In this instance, rather than undergo two procedures at one time, at one place, a woman is essentially told, "Sorry, you’ll have to pay another OR fee, and accept the risks of another round of anesthesia, another round of surgery, another period of recovery, because we don’t believe in what you want to do.”
Women who are raped and seek treatment at a hospital immediately afterwards, don't generally have - or even consider - a choice of hospitals. Catholic hospitals frequently do not provide emergency contraception to women in these circumstances, an issue which seriously impacts the health and lives of women in traumatic and emergency scenarios.
It's also important to note that religiously-affiliated hospitals receive public funding and tax breaks. The same women who are denied services are paying taxes towards keeping these centers open. The organization MergerWatch monitors religiously sponsored hospitals. They note:
Since the mid-20th century...religiously-sponsored hospitals have served an increasingly diverse population of patients and employ staff who are often not of the same faith as the hospital sponsors. Because many religious hospitals continue to restrict the services they provide, based on doctrine, there is a growing conflict across the United States between these hospitals and the diverse communities they serve. Patients may have no other convenient choice for hospital care, or may be restricted in where they can seek care because of managed care rules requiring members to use “in-network” hospitals.
The Maryland Health Care Commission is meeting on January 20th to make its final decision though Adventist's request to hold off on the decision and take their request for further investigation into consideration is still being considered. It seems more than appropriate for the state commission to present evidence as assurance that all women of Montgomery County, in Maryland, regardless of insurance coverage or ability to pay, will have access to contraception, fertility, tubal ligation or abortion care should Holy Cross be permitted to move ahead with its new hospital.