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When a church is affiliated with or runs a hospital, they are justified in having a say in how the institution is run. This principle is not only supported by basic religious freedom, but also by the fact that private organizations should have as much freedom as possible in deciding how they will operate.

But the situation just isn't the simple. The fact of the matter is, all hospitals - including Catholic hospitals - receive public funding. This occurs not only through the obvious Medicare and Medicaid payments, but even through the use of public bonding authorities to fund things like construction and improvement programs. This means that we taxpayers are financing religious restrictions on our own health care services. All of us - Catholic and non-Catholic - are paying to have Vatican doctrines deny things like voluntary sterilization, HIV prevention counseling and even simple referrals for birth control.

How is it possible for religious organizations to receive public funding and then deny legal health services to the public? Because Congress has granted them exceptions - starting with a "conscience clause" enacted in 1973 which permitted health-care organizations to refuse to provide certain services like abortion or sterilization if those services violated religious or moral convictions.

Although the original exceptions were limited to specific services like abortion, intense lobbying by religious organizations - particularly Catholic groups - is causing the exception to be broadened to include "any health service about which an ethical, religious or moral objection is raised." This is why even counseling about legal services is banned; as a consequence, people may not even find out what legal options they have. The Catholic Church has not been able to prevent certain options from becoming legal, but it is working hard to make sure that citizens don't become aware of what those legal options really are. Keeping the people ignorant is always one of the first and most effective steps on the path towards repression.

But wait, it gets worse. In 1997 Congress permitted Medicaid managed plans (which are publicly funded) to refuse to "provide, reimburse for, or provide coverage of a counseling or referral service if the organization objects to the provision of such service on moral or religious grounds." What does this mean? It means that if your health insurance is through a Medicaid plan managed by a religious group, you will no longer receive coverage for anything they don't like - even though the services are legal and funding comes from the public.

Has this happened? You bet it has - Fidelis Care, a Catholic Medicaid managed care program which is the sixth largest in New York City, has already taken advantage of this. They have 26,000 enrollees, mostly poor women, and they refuse to cover abortions, sterilizations, birth control, or even basic counseling for such services. These women now have to pay extra money to go "out of network" to find doctors or clinics to provide the legally available health care financed by the public.


Implications

It is not off-topic to point out that all of this carries great significance for the "public/private" partnerships which some politicians wish to create between the government and religious institutions. Some want religious groups to begin administering things like welfare, job education, counseling, and other government services. They say that this will make things cheaper and improve service because of the extra advantages brought by faith-based groups.

Sometimes, religious organizations even try to force actual government programs to abide by their religious edicts. In St. Petersburg, Florida, the city government attempted to lease space from the Catholic Diocese for a new community social service center. The purpose of Safe Haven, as it was to be called, was to refer poor citizens to other government and social services. Unfortunately, the lease stipulated that no referrals could be made for services which violated Roman Catholic doctrines. And editorial in the St. Petersburg Times observed:

It is not far-fetched to imagine that Safe Haven staff might be called upon to refer clients to Planned Parenthood for birth control information, including abortion services. ...Will information on safe sex have to be limited to a discussion of abstinence?

This substitution of sectarian authority for secular government couldn't be construed as anything but a violation of the separation of church and state. It is totally unacceptable for a church to tell government employees what they may and may not discuss with citizens who come to the government for advice and assistance. But that is exactly what certain church leaders - particularly Catholic Church leaders - would like to see happen.

Using the example of religious hospitals "partnering" with the government to provide health services, what are those "advantages?" Secrecy and limitations on people's legal choices. If religious organizations like the Catholic Church are permitted to administer publicly funded welfare services or substance-abuse counseling the same way they are currently permitted to administer publicly funded health care services, we can expect matters to get much worse.

We face even greater restrictions on our lives - restrictions which are not legally based but instead are based upon the doctrines of far-off religious leaders. Even political leaders have admitted that such schemes could well result in government-financed, religious-based discrimination. They don't bat an eye when they tell us that we may end up paying for bigotry at institutions like Bob Jones University! Because of this we need to draw the line where it is already happening before it gets worse and moves into other sectors of society.


Keep reading: Effects on Doctors.

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