The Cost of Care: A Personal Journey Through the Catholic Health System
When Jessica Staten, a long-time resident of Bellingham, Washington, faced the painful ordeal of kidney stones, she sought medical help at St. Joseph Medical Center, part of the Catholic health system PeaceHealth. What she anticipated would be a straightforward procedure turned into a financial nightmare, leaving her grappling with a staggering bill of $5,313.63. This experience highlights a growing concern about the intersection of healthcare, financial burdens, and the mission of Catholic hospitals in the United States.
A Routine Procedure Turns Costly
Staten’s journey began last November when her doctor recommended a procedure to "blow up" her kidney stones. After spending just 3½ hours at the hospital, she felt relieved that the procedure had gone well. However, the relief was short-lived when she received the bill. Despite having health insurance, Staten was informed that she did not qualify for financial assistance, as her income was deemed slightly too high. This left her with no choice but to take on additional debt, using her condo as collateral to secure a line of credit with an 11.2% interest rate—still a better option than the hospital’s payment plan, which would have charged her 12.5%.
“It’s all about the money,” Staten lamented, reflecting on her experience with the hospital. “That’s the way they think now at the hospital.”
The Mission of PeaceHealth
PeaceHealth’s mission, as stated in their 2022 tax filing, is to "carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way." However, Staten’s experience raises questions about how well this mission aligns with the financial realities faced by patients.
Victoria Wilson, a spokesperson for PeaceHealth, acknowledged that while the hospital offers interest-free 12-month payment plans, many patients still find these obligations unaffordable. She emphasized that each patient seeking care is in a vulnerable moment and that financial healing is closely aligned with their mission. Yet, the reality for many patients, including Staten, suggests a disconnect between the hospital’s stated values and the financial burdens imposed on those in need of care.
The Ethical Dilemma of Catholic Healthcare
The Ethical and Religious Directives for Catholic Health Care Services, issued by the U.S. Conference of Catholic Bishops, outline principles for social responsibility within Catholic health facilities. These directives emphasize the importance of promoting equity in care and addressing the health needs of marginalized populations. However, many patients and clinicians argue that modern practices at Catholic hospitals often neglect these responsibilities.
Shane Alderson, chair of the Baker County Board of Commissioners in Oregon, noted that the influence of faith organizations on hospital operations has diminished, leading to a corporate approach that prioritizes profit over patient care. This sentiment is echoed by many who have witnessed the transformation of Catholic hospitals from community-focused institutions to profit-driven entities.
The Financial Landscape of Catholic Health Systems
The financial practices of large Catholic health systems have come under scrutiny, particularly regarding executive compensation and community benefit spending. While these systems are required to provide community benefits to maintain their tax-exempt status, research indicates that many fall short of their obligations. The Lown Institute found that several Catholic health systems, including Providence and CommonSpirit Health, have significant "fair share deficits," meaning they spend far less on community benefits than the estimated value of their tax breaks.
In stark contrast, the compensation packages for executives at these health systems have soared. For instance, CommonSpirit Health’s former CEO earned approximately $28 million in 2022, while Providence St. Joseph Health’s CEO received $12.1 million. Critics argue that such disparities highlight a troubling prioritization of profit over patient care.
The Impact on Vulnerable Populations
The implications of these financial practices extend beyond individual patients like Staten. Research by Community Catalyst indicates that Catholic hospitals treat fewer Medicaid patients than their nonprofit counterparts, contradicting their mission to prioritize care for the poor and underprivileged. Additionally, aggressive tactics for collecting unpaid medical bills, such as lawsuits and wage garnishments, have become commonplace, further burdening those already struggling financially.
Patricia Gabow, a physician and former health system leader, emphasized that Catholic hospitals should be as zealous in enforcing social responsibility directives as they are in adhering to directives regarding reproductive and end-of-life care. The expectation is that Catholic health care should distinguish itself by advocating for those marginalized by society, including the uninsured and underinsured.
A Historical Perspective
The roots of Catholic healthcare in the United States trace back to the 19th century when nuns established hospitals to serve underserved populations. PeaceHealth’s first hospital was founded by nuns from New Jersey who ventured west to care for loggers and millworkers. However, as the healthcare landscape has evolved, the presence of nuns in leadership roles has diminished, leading to concerns about the loss of the original mission.
Today, PeaceHealth operates with a leadership team devoid of nuns, and the focus appears to have shifted toward corporate interests. The health system’s CEO, Liz Dunne, earned $3.6 million in the fiscal year ending June 30, 2023, while the Lown Institute estimated that PeaceHealth spent $108.7 million less on community investments than the value of its tax exemptions.
The Future of Catholic Healthcare
As the healthcare landscape continues to evolve, the challenges faced by patients like Jessica Staten raise critical questions about the future of Catholic healthcare. With consolidation leading to fewer choices for patients and rising costs, many find themselves in a precarious position, often feeling like a "captive audience" with limited options.
Staten’s experience serves as a poignant reminder of the need for a healthcare system that prioritizes patient care and social responsibility over profit. As Catholic health systems navigate the complexities of modern healthcare, it is essential that they remain true to their founding missions, ensuring that the vulnerable populations they serve are not left behind in the pursuit of financial gain.
In a world where healthcare costs continue to rise, the call for accountability and compassion in the medical field has never been more urgent. The hope is that by addressing these issues, Catholic health systems can reclaim their commitment to serving those in need, honoring the legacy of the nuns who once dedicated their lives to healing and care.