Franciscans and Healthcare: What is the Future?

HEALING AT THE HEART OF OUR MISSION: RESPONSE TO NAIRN

114 HEALING AT THE HEART OF OUR MISSION RESPONSE TO NAIRN Kenneth Himes, O.F.M. I want to begin by thanking Tom Nairn for his remarks. And I also am indebted to him for preparing his remarks far enough in advance that I had a chance to read them and prepare my reaction. Here in Washington one lives in the land of lobbying and special interest groups. Such groups often vie for the coveted title of being grassroots groups, groups that express the real interests and concerns of real people who live outside the Beltway. But not all groups claiming to be grassroots really are. In fact, some groups are better thought of as “artificial turf” groups since they represent few people and are usually the creation of some person with access to foundation grants. These groups exist on the right (Robert Sirico’s Action Institute) and the left (Frances Kissling’s Catholics for Free Choice). They get the attention of the media who want controversy and therefore need to portray issues from the perspective of polar opposites. Such artificial turf groups work hard trying to draw attention to themselves with press releases and news conferences. But we ought not be deceived into thinking they are remotely representative of what the grassroots really thinks. They have almost no dues-paying members or popular support. So I would not worry that Frances Kissling is suspicious of Catholic healthcare. Most Americans are not. In fact, it is precisely through healthcare that many non-Catholics first came to have contact with and respect for Catholic institutional ministries and the religious women who served in such settings. When we take up the question of identity and Franciscan healthcare we should be clear why we are doing so. I would suggest that the issue is not theological. Healing is at the heart of the Church’s mission. As the motto of the Catholic Health Association states: “The Love of Christ Impels Us.” No one really doubts that our healthcare institutions can be wonderful sacraments of God’s HEALING AT THE HEART OF OUR MISSION 115 presence amidst the human experiences of illness and healing, suffering and death. The discussions about identity have not been occasioned by any theological questions related to the mission of healthcare. Rather the topic has emerged for three other reasons— historical, financial, and ethical. Historical There is a declining number of qualified vowed religious to staff, administer, or govern the institutes they founded. Lay leadership, which was 30% in 1970, is now more than 70%. What does that mean for Catholic or Franciscan identity? Religious have been creative in responding to this phenomenon . Much material and many actions have resulted in three common responses: strategies of sponsorship, creation of administrative offices devoted to mission or charism, and development of lay leadership programs. Financial The ground is shifting beneath our feet. Healthcare has become commercialized. For-profit organizations have moved in and spawned competition and preoccupation with bottom-line decisions. Hospitals are medical centers, administrators are CEOs, patients are consumers, caregivers are providers. The vocation of dedicated people has been trivialized and cheapened. But the changes are not just market-driven, for both government and medicine have promoted change—acute care hospitals are no longer the center of healthcare, managed care and capitation schemes are replacing feefor -service insurance plans, integrated delivery networks provide comprehensive community health services. As a result, individual hospitals, even hospital systems, either will not continue to exist in total independence or will close. Ethical The changes forced by the first two factors highlight the need to struggle with identity in the midst of a new ethical challenge. How do we maintain a distinctive Franciscan identity amidst a deeply pluralistic society? 116 KENNETH HIMES, O.F.M. I want to focus on this third cause for wrestling with identity— the ethical. There are, of course ethical issues embedded in the second set of causes, the financial, but I have addressed these in print already. 1 They are not the focus here. It is wise to focus on what is distinctive as opposed to what is unique. This is a common way for moral theologians to talk. Uniqueness, what is peculiar or differentiating, is not unimportant, but it is often not what is most important. For example, being uniquely Catholic can be characterized by allegiance to the papacy, forms of Marian devotion, or certain specific moral...