American Catholic Hospitals: A Century of Changing Markets and Missions by Barbra Mann Wall (review)

American Catholic Hospitals examines the developments in U.S. Catholic health care during the past 100 years. Barbra Mann Wall contends that as leaders of Catholic hospitals reacted to

increased societal secularization over the course of the twentieth century they extended their religious values in the areas of universal health care, abortion, and reproductive services, which led to tensions among the values of the Church, the government, and society.

(p. 2)

To document the changing face of Catholic health care, Wall focuses on four primary examples: the Sisters of Providence in the state of Washington; the Alex-ian Brothers’ hospital in Chicago; the health care system in Austin, Texas, founded and administered by the Daughters of Charity of St. Vincent de Paul; and Chicago’s first chartered hospital—Mercy Hospital, founded by the Sisters of Mercy.

Catholic hospitals were forced to respond to changes taking place in both society and the Church if they hoped to survive. Declining numbers of men and women religious, shifting demographics, the passage of Medicare and Medicaid, and the responses of religious congregations to the decrees of the Second Vatican Council had a tremendous impact on these institutions. These four factors meant that the Alexian Brothers, for instance, divested themselves of some hospitals, whereas the Daughters of Charity formed the Seton Healthcare Network, which by the late 1990s was the third largest private employer in Austin and its environs. Chicago’s Mercy Hospital, which was founded in 1851, remained on the city’s Near South Side, but found it necessary to attract more paying patients so as to maintain financial solvency and remain faithful to its mission. The Sisters of Providence, who administered and staffed an extensive system of health-care institutions on the West Coast, transferred control of some hospitals to other groups or agencies so that they could devote themselves to unmet community needs.

In addition to examining the ways in which Catholic hospitals confronted issues related to declining numbers of women and men religious and changes in federal health care policy, Wall devotes chapters to gender, race, the relationship between Catholic hospitals and the federal government, and situations in which hospital workers either threatened to strike or actually walked off the job over issues related to salary and working conditions.

The final chapters of the book focus on challenges faced by these institutions in the twenty-first century. The merger of Catholic and non-Catholic hospitals, for example, must be “understood in the broader context of national health care issues”(p. 156). Concerns related to reproductive services complicated these mergers, and the institutions’ missions to serve those oppressed by society and “preserve the rights of the unborn, … often clashed head-on with practices of secular hospitals not constrained by the same moral guidelines” (p. 175). The full effect of the Affordable Care Act on religious health care institutions remains to be seen.

American Catholic Hospitals is meticulously researched and well written. Although it is certainly appropriate for both undergraduate and graduate students, general readers also will find it to be an excellent overview of the history of the changes that Catholic health-care institutions have undergone in the twentieth and twenty-first centuries.