By MARY LYN BUSS
For The Beachcomber

Ever since Highline announced it was selling itself and all its subsidiaries to the Franciscan Health System, there has been a lot of angst rumbling around the island.

Seniors in a Regence MedAdvantage plan have been told the clinic no longer participates as a preferred provider with that plan, according to local activist May Gerstle. Some patients have quit the clinic altogether. Center employees have lost insurance coverage for contraception. Many islanders fear sectarian interference in their health care. I believe women are tallying up the cost in time and money of going off-island for routine care. And others, like letter writer Mary Frances Lyons (“Franciscans aren’t ideal, but may have saved the center,” Oct. 30), fear that if we rock the Franciscan boat too much, we will lose our health center altogether.

Take a big breath. We do have a problem here, but we are not alone. Merger mania grips the nation. In the old days when doctors were independent and hospitals were just hospitals, people had choices. Now hospitals are morphing into giant health care systems, buying up other hospitals and acquiring physician practices, clinics, labs and ancillary services of all sorts. There is no equivalent of the Federal Communications Commission to temper health provider consolidation or look out for the public interest. Only recently have our state’s attorney general and insurance commissioner awakened to their duty to represent the public interest.

All employees of the Franciscan system, including those at the Vashon center, are required to abide by the “theological principles that guide the Church’s vision of health care,” according to the Catholic Church’s Ethical and Religious Directives, which outline Catholic health services’ principles and their detailed application to real-life medical situations. This document is the product of the U.S. Conference of Bishops. The bishops, all men, overwhelmingly white and old, are theologians. They are not medically trained or medical ethicists. The directives are rooted in church doctrine. They concentrate on sex and reproduction and on death and dying. Death with Dignity, goodbye. Good luck with the rhythm system.

Ten out of the 25 largest health care systems in the United States are now Catholic owned. While Catholics comprise less than 12 percent of our state’s population, by the end of this year, Catholic systems are predicted to control half of the hospital bed capacity in Washington. The bishops’ directives, now in their fifth edition, predate the current nationwide wave of mergers. Yet the directives address doctors and patients as if all were all compliant practicing Catholics.

There is a real problem here, and we should not keep quiet about it.

We need to join in the statewide and even national conversation about limits on imposition of religious beliefs in the workplace on those who do not share them. Religious exemptions and conscience clauses have been very popular with the anti-abortion crowd. Do we need a legal conscience clause for health care providers to act in accord with their professional oath and conscience even when in conflict with corporate religious beliefs? Can corporations require, as a condition of employment, that a doctor pledge obedience to a religious doctrine that conflicts with his or her professional oath or religious beliefs?

Health care is not a privilege. It is as essential as food, shelter and education. It is also a highly regulated and taxpayer-supported industry. Is there any hospital in America that doesn’t depend on substantial taxpayer/government money and tax exemptions? Hospitals are licensed to provide public services. Can they discriminate willy nilly on religious grounds? No to women? No to gays? When a large hospital or provider network becomes a monopoly in an area, shouldn’t it be required to provide a full range of legal health care services compatible with its type of services it provides?

There are working examples of mergers structured to protect physicians’ integrity and ability to follow medical best practices. There have been some efforts to assure that reproductive health services remain accessible and local. Surely religious health care systems know that it is unrealistic to think that they can impose their religious dogma on everyone who works for them or gets services from them. They may not be able to work up the hierarchy for change, but some have shown willingness to work out creative solutions. We need to keep talking.

— Mary Lyn Buss is a member of Vashon HealthWatch and has a law degree with an emphasis in health law. For more information on Vashon HealthWatch, contact vashonhealthwatch@outlook.com.