Do They Know Who They’re Messing With?

During a recent conversation about the HHS anti-conscience mandate, a friend who is neither Catholic nor particularly religious asked the following rhetorical question about the Obama administration:

Do these people know who they’re messing with?

Her point, of course, was that the Church has spent nearly two millennia crushing attempts by secular rulers to dictate the way it carries out its charitable ministries. Commanding Catholic hospitals to fund sterilizations, contraceptives, and abortifacients isn’t like twisting the arm of some roundheel congressman. It’s going to take more than the usual Chitown chicanery to cow a venerable and well-funded organization that has brought more than one emperor to his knees.

The Church’s charitable work has been seen as a threat to the power of the state as far back as the reign of Julian the Apostate. Julian was the Roman Emperor who tried to drag his subjects back to the crumbling altars of the old state gods a half a century after his uncle, Constantine I, had legitimized Christianity by converting to the new faith. Julian’s project didn’t go well, and he complained in a letter to one of his high priests that the effort was failing because “the impious Galileans support not only their own poor but ours as well.” What’s an Emperor to do with opponents whose tactics include such dirty tricks as lending aid and comfort to all who need it, including people with religious and political views that differ from their own?

Julian tried to counter the effect of such “impious” tactics by restructuring the imperial administration in such a way that it could compete with the “Galileans” in good works and thereby erode the connection in the public consciousness between charity and the Church. In a move that eerily echoes the progressive vernacular of our own age, Julian issued the Tolerance Edict of 362. The purpose of this decree, like calls for tolerance from modern liberals, was precisely the opposite of its ostensible intent. It re-privileged the old pagan cults, rescinded religious freedoms recognized by Constantine and attempted to sow dissention among Christian ranks by reigniting long-resolved doctrinal controversies.

The Tolerance Edict and a variety of similar edicts flopped. And, after Julian’s short reign ended, his successors gave up his pagan revival project as a bad job. But the meaning of Julian’s failure has been lost on many subsequent rulers, and Barack Obama is among the slow learners who refuse to heed the lessons of history. The president, like Julian, wishes to “transform” his country into a place in which every aspect of the citizen’s life is connected to and controlled by the state. He wants the federal government to be seen as the ultimate arbiter and provider of the electorate’s needs. Obviously, however, this can’t be managed while large and influential institutions like the Catholic Church and its charitable ministries remain in place.

And, where health care is concerned, Catholic institutions are definitely a force to be reckoned with. For example, they provide care to one in six patients treated in the United States every year. During 2010, America’s more than 600 Catholic facilities treated well over 100 million patients, including 19 million emergency patients, and 5.5 million inpatients. And much of the care received by these patients was provided at a loss. Of the 5.5 million in-patients treated by these hospitals during 2010, 3.3 million were covered by Medicare or Medicaid, both of which pay less than the amount it costs to provide treatment. Of the 19 million emergency patients treated at Catholic hospitals, a large percentage paid nothing at all.

So, what happens if the Catholic hospitals simply refuse to abandon their principles and decide to get out of the health care business? This possibility is not as remote as some may believe. Don’t forget what happened in Massachusetts when Catholic charities faced a similar choice relating to adoption. Rather than abandoning their principles they simply stopped offering adoption services. If they take the same course in health care, the effect on our medical delivery system will be disastrous. Not all of the Church’s 600 hospitals would disappear, of course. Some would be bought by large for-profit chains, like HCA. Others would be picked up by big not-for-profit systems. But at least a third would probably go out of business.

And that third will consist mostly of rural and inner city hospitals that treat the nation’s most vulnerable patients. These institutions will never show a positive bottom line because most of their patients are covered by government insurance or none at all. They are only open at present due to the good graces of the Catholic Church and its members. Once those good graces are withdrawn, there will be no buyers and these hospitals will be forced to shut their doors. Where will their patients go for care? The rural patients will have to travel for hours, in some cases, to access care. And many will die on the way. The inner city patients will go to hopelessly overcrowded safety net hospitals where patients already die in the waiting rooms.

Would the Church really withdraw from U.S. health care? In a recent letter to all the Catholic bishops of the United States, Cardinal Timothy Dolan wrote, “We have made it clear in no uncertain terms to the government that we are not at peace with its invasive attempt to curtail the religious freedom we cherish as Catholics and Americans. We did not ask for this fight, but we will not run from it.” In the same letter, Cardinal Dolan quotes supportive words from the Pope: “We recall the words of our Holy Father Benedict XVI to our brother bishops on their recent ad limina visit: ‘Of particular concern are certain attempts being made to limit that most cherished of American freedoms, the freedom of religion.'”

I, like my friend, am not a Catholic. And I am certainly no expert on Church politics. But the Cardinal’s letter to the bishops does not read like a bluff. It is true, of course, that the Church is no longer as powerful as it was in Julian’s day or 700 years later when the Holy Roman Emperor was forced to walk across the Alps and stand barefoot in the snow begging for an audience with Pope Gregory VII. But it is by no means without influence in the modern era, as the conspicuous absence of the Soviet Union attests. If Cardinal Dolan is not Gregory VII, neither is he Bart Stupak. When he writes, “As our ancestors did with previous threats, we will tirelessly defend the timeless and enduring truth of religious freedom,” I think he means it.

Nonetheless, it isn’t at all clear that Obama, his cadre of Chicago sycophants, and their accomplices in the media do understand “who they’re messing with.” If they think the absurd Sandra Fluke and their phony crusade against a fictional “war on women” will make the very real issue of religious liberty go away, they are even dumber than their policies suggest. In fact, it could mean they are so clueless that it may indeed be possible to beat them in November — even with Mitt Romney as the GOP presidential nominee.

David Catron is a health care finance professional who has spent more than twenty years working for and advising hospitals and medical practices. He blogs at Health Care BS.

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