REPRODUCTIVE CARE: Catholic Mergers Limit Access In Northern California
As financial pressures mount in California, religious health care providers are reorganizing -- partnering up with nonreligious hospitals, buying practices and setting up HMOs. But the mergers, which are increasing the pull of religious health care systems, mean a decline in reproductive health services being offered to consumers in Northern California and the Sacramento area, the Sacramento Bee reports. When religious hospitals, particularly Catholic ones, merge with non-secular facilities, they often put restrictions on the reproductive services that can be provided there, most often banning physicians from performing abortions or tubal ligations.
The Bee reports that the local impact of this trend has taken "a variety of forms." In Northern California, three non-Catholic hospitals stopped providing abortions after merging with Catholic-run Mercy Healthcare Sacramento. In Susanville, the only hospital is Catholic and will not provide abortion services or sterilizations. A doctor who wanted to rent space from Santa Rosa Memorial Hospital, a Catholic facility, was asked to sign a lease that said she would adhere to the bishops' directives on reproductive health care. And a woman in Fresno found that her insurer would not pay for a tubal ligation because it had an exclusive contract with St. Agnes Hospital, which bans the procedure.
While consumers in or near urban areas can often go elsewhere for reproductive care, women in rural areas may be out of luck. Lassen Community Hospital is "the only hospital in town" and has not provided abortions since becoming Catholic-owned in 1986. "I have no idea where [abortions] would be done," said hospital administrator David Anderson. Lassen County women seeking a tubal ligation must leave the county, which means "travel[ing] 100 miles over winding roads to Chico, or even farther to Redding or Sacramento." Even then, some must find a provider who accepts Medi-Cal. "The biggest problem is that people who would get it done if it were convenient and available don't get it done ... and get pregnant again," said Dr. Paul Holmes, who heads Northeastern Rural Health Clinics in California. But some providers are happy with the arrangement and say they have worked with Catholic providers to keep some of the services they had previously offered. "Affiliation has given us long-term financial stability. That was the major factor why we decided to do it, and Mercy seemed to have the values closest to us in terms of being a community hospital," said Dr. Joe Lloyd, an anesthesiologist at Sierra Nevada Memorial Hospital in Nevada City, which merged with Mercy Healthcare in 1995. "We were aware of Catholic restrictions ... and spelled out the things we wanted to maintain as a community hospital," he said (Clegg, 7/18).