It’s been a long time since I heard anyone say “Reasonable people can disagree on this issue.” More often the outlook seems to be, “If you don’t agree with me you can’t be a reasonable person, and you’re not in my tribe.” And for far too many religious people, politics and elections have taken on apocalyptic overtones. Reasonable is not a word that comes up in any conversations. 

One issue that is gaining prominence among reasonable people and others is the role religion is playing in healthcare. Driving the issue are two separate forces: the courts and Catholic hospital systems. Catholic hospitals are a growing presence in healthcare. They control one in seven hospital beds across the country and they use Catholic doctrine in deciding what procedures they will provide. That rules out abortion, affecting availability even in states where it remains legal, but these hospitals are also likely to deny vasectomies, tubal ligations, contraceptive services including IUD’s, and in vitro fertilization.

Four of the seven largest hospital systems in the country are Catholic. As financial pressures force small hospitals to close or merge, many are merging into Catholic systems where they must adopt the religious constraints of their new owners. Yes, there have always been Catholic hospitals and you don’t have to go to one. Unless it’s your only option. In 2020, there were 52 hospitals operating under Catholic restrictions that were the only community providers of short-term acute care in their area. Up from 30 hospitals seven years earlier. And too frequently the faith-based restrictions on care are not made clear to people before they arrive at one of these hospitals or urgent care clinics. 

The other threat to secular, science based healthcare is court decisions that allow private companies to opt out of providing healthcare services because of religious beliefs. Because our public healthcare system relies on private corporations, we are faced with loss of care that benefits the population at large when a single private entity asks a judge to allow it to refuse some type of coverage or service because of its “faith.” 

The most recent of many examples is a federal judge’s ruling that employers don’t have to cover a drug that helps prevent H.I.V. infections because it might encourage gay and extramarital sex. This follows rulings on vaccines, contraception, and other medical issues that affect the general population but cater to a small religious segment. What to do? One small bit of good news in this area is that the Supreme Court only hears about two percent of all petitions so most of the others are decided by the lower courts, and the current Administration has been successful in confirming judges to fill vacancies there. If that sounds good, you need to vote to keep the Senate the way it is. 

Some states have taken the lead in requiring Catholic hospitals to be transparent about what services they don’t require and to prevent mergers from reducing services at hospitals. We will be talking to members of the Congressional Freethought Caucus before the new Congress begins in January about legislation that would require hospital systems that accept billions of Medicare and Medicaid dollars to address these issues. Issues we hope to find reasonable solutions to.