Health Care and Theology

I opened my email this morning to find this news alert from the New York Times: 

Monday, August 6, 2012 -- 6:38 PM EDT

Hospital Chain Internal Reports Found Dubious Cardiac Work     


HCA, the largest for-profit hospital chain in the country, is confronting evidence of unnecessary cardiac treatments at some of its medical centers in Florida after a nurse’s complaint prompted an internal investigation. The inquiry found that the complaint was far from the only evidence that unnecessary — even dangerous — procedures were taking place at some HCA hospitals, driving up costs and increasing profits.

HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports.

We all need money and in that sense we all need to make a profit. Businesses need to make a profit. I wonder, though, about necessary human services. We don't tax food because it is a necessity. It could be a significant revenue source for the state and city, but we agree that as a society it would be morally wrong to do it. 

I've often questioned "for-profit" medical care. In my experience those who pursue medical careers do so for the best of reasons. But economics is a powerful force. When a human necessity like health care is based on making a profit, something crucial is lost in the transaction between doctor and patient. When a system knows that the bottom line is making a profit or close down, health care service cannot help but be influenced.

Florida is one location out of many in the country. HCA is one company, even if the largest, providing health care in the country. It is clear that the bottom line has effected how it provides medical care to patients. If the profit lies in medical procedures, increase them. Simple. And corrupt. 

The doctors involved, if they were tampering with medical records, know their own code of ethics and are aware that what they were doing was wrong. There was something more powerful than their own code of ethics at work and it has to be the presence of a bottom line mentality in the system. 

Human services cannot easily embrace a for-profit mentality. What profit, financially, is there in helping the homeless? In providing health care for low income populations? How many can even begin to pay for the expensive procedures available today? Those who work in health care are more aware than I am of the economic issues at hand. I just cannot understand why we would even want to apply the profit motive to health care in the first place. It doesn't fundamentally fit the service. 

Theologically, health is not merely physical. It is a spiritual matter, something that embraces the whole person. It isn't a commodity. It does not, or should not, carry a price tag. But in a capitalistic economy, at least one that has become ideologically capitalistic, nearly everything is subsumed under the idea of economic profit. This is also eating into education, including seminary education for religious leaders. i don't know where this ends, but it seems to have a short shelf life down the road. We will see. But viewing health and health care as a spiritual matter, subject to a code of ethics that honors the dignity, in Christian terms, of the person created in the image of God, then we are bound to consider it differently than as a service designed to maximize profit. Where to draw the lines is complex, but the fundamental assumption we make is important to the outcome.