Inquiry: A Journal of Medical Care Organization, Provision and Financing
Catholic hospitals maintain a significant presence in delivering hospital services in the United States, but little is known about the ways they differ from other ownership forms in similar market environments. This paper analyzes characteristics of Catholic, other private nonprofit, and investor-owned hospitals in metropolitan areas of the United States to identify the extent to which Catholic hospitals differ from other ownership types on three dimensions of mission-driven identity--access, stigmatized, and compassionate care services.
This article provides an account of how AndrÈ Hellegers, founder and first Director of the Kennedy Institute of Ethics at Georgetown University, laid medicine open to bioethics. Helleger's approach to bioethics, as to morality generally and also to medicine and biomedical science, involved taking the "wider view" -- a value-filled vision that integrated and gave meaning to what otherwise was disparate, precarious, and conflicting.
As part of its mission to honor human dignity and to care for the poor and vulnerable, Catholic Healthcare Partners (CHP), Cincinnati, has made a systemwide commitment to address housing needs in the communities it serves. A priority for the system is providing safe, affordable housing options for the low-income elderly. CHP's approach goes beyond "bricks and mortar," however. The system aims not only to provide a home for senior adults but also to enrich their lives.
The Sisters of Charity Health System, Lewiston, ME, a member of Covenant Health Systems, Lexington, MA, remains deeply committed to the mission of service begun by its foundress, St. Marguerite d'Youville. Although St. Marguerite experienced a hard life, her resilience and her commitment to the poor and disadvantaged serve as an inspiration to those who continue her legacy of compassionate care. The founding work of St. Marguerite and the sisters has helped to foster a culture in which the mission of service thrives among the system's 2,000 employees.
"Community benefit" is the measurable contribtution made by Catholic and other tax-exempt organizations to support the health needs of disadvantaged persons and to improve the overall health and well-being of local communities. Community benefit activities include outreach to low-income and other vulnerable persons; charity care for people unable to afford services; health education and illness prevention; special health care initiatives for at-risk school children; free or low-cost clinics; and efforts to improve and revitalize communities.
BACKGROUND: Catholic hospitals and health systems comprise a substantial segment of nonprofit, mission-driven, health care services, with accountability to institutional pressures of the Roman Catholic Church as well as economic pressures for solvency. Values are the way in which the organization expresses its faith-based institutional identity, which may used to select services that represent those values.
The 2010 Patient Protection and Affordable Care Act (ACA) requires not-for-profit hospitals, including Catholic hospitals, to engage in meaningful community assessment and collaboration efforts in order to maintain their tax-exempt status. Now that the ACA has been upheld by the U.S. Supreme Court, this paper argues that the requirements related to a more robust community engagement process should be embraced by Catholic not-for-profit hospitals and health systems.
This article documents the historical factors that led to shifts in mission work toward a greater emphasis on community health for the poor and most vulnerable of society in sub-Saharan Africa after 1945. Using the example of the Medical Mission Sisters from Philadelphia, Pennsylvania, and their work in Ghana, we challenge the conventional narrative of medical missions as agents of imperialism.
A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics of health care.