System grapples with complexity, financial scope

What has slipped from public view in the past half-century is how huge a system Catholic health care is, and the extent of its service to the society at large.

If, for example, U.S. Catholic health care were transplanted to Britain, it single-handedly could serve more than half the British population. Britain’s National Health Service meets the needs of 58 million people with 1,200 hospitals; U.S. Catholic health care has more than half that, 625 hospitals.

In terms of finances, the smallest U.S. metropolitan area Catholic hospital has a larger budget than the Vatican’s $200 million in annual revenues.

Again, stressing only its complexity and financial scope, the combined revenues of Catholic health care’s 68 systems, some $30-plus billion annually, undoubtedly exceeds the annual funding responsibilities of the entire Europe-wide Catholic church.

That $30-plus billion is up there with Bill Gates’ $40 billion fortune, greater than the Gross Domestic Products of the poorest 16 African countries combined.

Catholic health care is a huge system driven by Catholic belief and sentiment that grapples with the revenue ills afflicting all nonprofit hospitals (because they serve such a high-percentage of Medicare and Medicaid patients in an era when reimbursements are being reduced to lower-than-costs levels). Plus Catholic health care has to be politically astute -- inside the Beltway, before state legislatures, and locally, because there is opposition to its receiving public monies and a “conscience clause” exemption on contraceptive services (NCR, June 20).

At the same time, Catholic health systems must remain financially appealing on Wall Street for short- and long-term bond funding. Bonds are a Wall Street investment tool. Nonprofit hospitals -- like local school boards and other services -- need access to bond market funds for essential expansion, new equipment and building programs.

Some balancing act!

-- Arthur Jones

National Catholic Reporter, July 18, 2003