Patricia Miller has a chilling article over at Salon titled When the Catholic Church owns your doctor: The insidious new threat to affordable birth control. Miller’s article opens with a story about a woman named Angela Valavanis. According to Miller, Valavanis’s first bad encounter with the Catholic health care system happened just after she delivered her second child at St. Francis Hospital in Evanston, Illinois. The Catholic hospital “refused to allow her OB/GYN to tie her tubes because of Catholic restrictions on the procedure.” When she went for a postpartum checkup with her OB/GYN, Valavanis asked about going back on the Pill because she hadn’t gotten the sterilization she wanted while she was in the hospital. That’s when “she got another shock.”
Valavanis said, “My doctor told me that she couldn’t prescribe birth control because she had sold her practice to a Catholic health system.” Valavanis said her “mouth dropped open.” She added, “I was so confused to hear those words coming out of the mouth of an OB/GYN.”
An OB/GYN who can’t prescribe birth control? It’s not some bad joke. It could be a reality if your doctor’s practice is purchased by a Catholic health system that then imposes the Ethical & Religious Directives for Catholic Health Care Services, a set of rules created by the U.S. Bishop’s Conference that prohibits doctors from doing everything from prescribing the Pill to performing sterilizations or abortions.
Miller noted that Valavanis’s “experience may be just the tip of the iceberg.” She said that health systems—which are a collection of hospitals and ancillary services—“are acquiring physician practices at an unprecedented rate.” She added, “The percentage of doctors who were employees of health systems increased from 20 percent to 26 percent between 2012 and 2013 alone; more than 40 percent of primary care doctors like OB/GYNs are now employed by health systems directly, and experts don’t see the trend slowing.”
According to Miller, Catholic hospital systems account for eight of the 10 largest nonprofit health systems in this country. She said that these hospital systems “are poised to become major owners of doctors’ offices, which could severely impede access to contraceptives if doctors are forced to follow the Directives.’
Lorie Chaiten, director of the Illinois ACLU’s Reproductive Rights Project, cautioned, “The more we see these Catholic systems buying up these practices, the more we are going to see what Angela saw.” Chaiten noted that “such refusals are legal under Illinois’ Health Care Right of Conscience Act.” Chaiten added, “Angela went to the same provider for 15 years and all of the sudden she couldn’t get birth control. This could have a huge impact on women.”
Presence Health, the largest system in Illinois, is reportedly “also prohibiting doctors from providing contraceptives.” Miller said that “Presence was created by the merger of two smaller Catholic systems, Resurrection Health Care, which was the system that bought Angela’s doctor’s practice, and Provena Health.” According to Miller, Presence Health currently “owns 11 hospitals and dozens of doctor’s offices.”
These health systems are merging, and gobbling up doctors’ practices, because of incentives in the ACA for systems to coordinate care across the range of services that patients need, from doctor’s visits to in-patient hospital procedures, and because of health care economics, that make it prohibitively expensive for doctors to maintain solo practices.
Asked directly whether its doctors in Evanston and elsewhere in Illinois were prevented from providing contraception, Presence said in a statement, “We abide by the Ethical & Religious Directives, and there are certain services which we do not provide. It is our expectation that all physicians associated with Presence Saint Francis Hospital share with their patients the options that are available in accessing the care they seek.”
BTW, after Valavanis’s OB/GYN refused to give her a prescription for birth control pills, her husband told his doctor he wanted to get a vasectomy. Guess what happened?
His doctor, who was also part of the Catholic system, said his practice couldn’t do the procedure or make a referral.
Angela Valavanis said, “The whole situation is so unbelievable to me. I had no idea these limitations occurred. When I tell my friends about it, they say it’s medieval. We have to worry that if they keep buying up all these practices, it will get harder and harder to find someone who can prescribe birth control.”
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