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[The conversations represented here took place over the last week and are compressed for your reading pleasure. My husband and I are real people and said the things represented here. The rest of the dialogue is provided by intentionally fictionalized characters that are not meant to represent any one person. All sentiments and facts expressed here are genuine to the best of my recollection, but the characters saying them were selected by drawing names from a hat. I, alone, am responsible for this content.]

The Quickening

“They canceled Andrianna’s tubals yesterday,” I inform Steve in the hall outside the conference room. “They didn’t even give her a whole day’s notice so she could talk to her patients before they did it.”

"I got virtually no notice either when they canceled mine on Monday,” he replies.

“Really?” I am shocked by this. I have never heard of a hospital canceling cases so abruptly without involving the surgeon. “Who ordered the cancellations like that?”

“Don’t know. We’re only told the surgery scheduler, but someone gave her the order.”

We enter the conference room to find Norm waiting for us. The other gynecologists filter into the room. Both the hospitals the Sisters of Orange own are represented: the hospital in my town, St. Joseph’s, and the one south of us, Redwood Memorial.

“We had hoped this would blow over but the sisters feel backed into a corner.” Norm starts. “They have no choice but to get tough on this issue.”

“What brought all this on?” Steve asks.

“The edict came down from the new Bishop in Santa Rosa," Norm says, "but we got targeted when they pulled the diagnosis codes for the hospital. It was obvious we were doing more sterilizations than they were in Southern California.”

“In Southern California you can go down the street from any Catholic institution and run into a secular hospital.” I try to defend us. “The Catholic Church bought almost all the hospitals in this area. For the last six years they’ve been trying to drive the last secular hospital under.”

“Never the less, we were doing a lot of tubals for ‛psychological’ reasons.”

“We were hardly doing a lot of sterilizations,” I say. “Other hospitals preform far more tubals a year. The stigma the Church gives the procedure already curtails many woman from asking for sterilization.”

“So what’s the plan?” Steve says, rescuing the meeting from disintegrating into complaints about the Church.

“Nothing.” Norm states. “This is a game we can’t win. The more public pressure the Catholics face, the more they will dig in. We have to keep quiet and wait. That will take the pressure off the nuns. When you’re approached by the media, and you will be approached, my advise is to refer them to the CMO. That’s what he gets paid for. Don’t talk to the media, or write letters to the editor. Don’t talk to your patients about it. We need to keep the lid on this to stop it from blowing up.”

“Too late. The patients already know.” I inform him. We all know there was an article in the local alternative paper, The Journal. The “real” paper in town, the Times Standard, has been silent on the issue. “I spent half an hour at a Pap smear today with an irate woman who vented the whole time about how this was unreasonable and unfair."

“I wouldn’t encourage her. And don’t talk to your staff about this either,” Norm says.

“How am I going to do that? I’m taking my patients to Mad River. They all know why I stopped operating at St. Jo’s.”

“What do you say to the patients?” Steve wants to know.

“The truth. I don’t think it’s fair to deny all the women in an entire county a procedure on religious grounds. And the patients agree with me. I have an eighty year old woman who lives as far south in the county as you can go. I told her why I was taking my patients north, but seeing where she lived and considering her age I told her I would make an exception for her and operate on her at St. Jo's. She told me, ‛Don’t you dare. I don’t want to support that any more than you do.’ This octogenarian wants to drive past the two hospitals the Sisters own to have her surgery at Mad River Hospital.”

“This hospital is facing hard times right now.We're barely holding on ourselves. We can’t afford to lose any patients. We don’t want to lose patients or doctors.” Norm seems genuinely alarmed.

“Great. Go back to the way it was, and I’ll bring my surgeries back to St. Jo’s.” I feel for Norm, but I will not be moved.

“Look, if they made us take all the hysterectomies to ethics committee, the way they threatened to, then I would do the same thing.” Wendy said. “But it’s just the tubals.”

“The only reason they didn’t is because they found out the insurance companies already reviewed all our hysterectomies and would not pay without an adequate medical diagnosis.” I tell her. “They weren’t being magnanimous. They just didn’t want to duplicate the work.”

“You can’t take your surgeries to Mad River.” Quinn, always the practical one, tells me. “I’ve looked at the labor numbers. St. Jo’s is hemorrhaging money in Obstetrics. The hospital will take the Laborist program away. The only reason you came here was for that program. You don’t want to see it die, do you?”

“I don’t.” Everything he says is true. Medicaid doesn’t even cover the cost of deliveries for most hospitals. The one wing devoted exclusively to women is a loss leader for most hospitals in the nation. Obstetricians get treated like the red-headed-step-children of the family of physicians because we don’t make the hospital any money. Having a Laborist program is a rare luxury. It meant I could sleep through the night for the first time in years, watch a whole movie in a theater, have a conversation with my husband--uninterrupted by the other woman...one with vaginal discharge. I do desperately want to keep that indulgence. “It’s not just about what I want. If they take the Laborist program, there's little reason for me to be at St. Jo’s at all. I’ll not just take surgery to Mad River, I’ll take my labor patients as well.”

“If we don’t support the hospital it won’t be there to care for us.” Wendy says. “I for one want a hospital here when I retire.”

“Not taking care of the needs of half of the population is not caring for us.” I can feel my control slipping. “If they are unwilling to serve half the population’s health care needs, what are they doing in the business in the first place? They should sell the hospital—preferably back to the community to be run cooperatively.”

“This happens every seven years or so.” Elroy, the oldest member of our tribe, says. “The last time it was a new nun sent to take over the hospital. She had all the tubals canceled too.”

“How did that get resolved?” I ask.

“She died and it got forgotten.”

“So we’re waiting for the Bishop to die? Or just waiting for him to change his mind?” I say with more than a little heat. “The Bishop isn’t the only one with strong feelings on this.”

“The hospital can make it hard for you.” Adrianna has arrived late to the party due to her patients. “Remember Tony? He got in that spat with the hospital and started talking to people—even people in the Foundation. It got back to the Board of Trustees and they dragged him into Medical Executive Committee. Now he has that mark on his record forever.”

I know she is trying to warn me. I’m no stranger to this tactic. Though I have not seen it used at St Jo’s, I’ve seen it used elsewhere to strike fear into doctors. A hospital will use its power to remove incompetent doctors on a doctor who is medically competent but has a disagreement with the hospital. They sacrifice one physician, ending his or her career, to scare the other physicians into compliant silence. There are even courses for hospital administrators instructing them how to do this effectively. I’ve avoided such abuses of power so far, but I’ve seen it used time and again on colleagues.

“Look, it’s not just our patients. I was already scheduled to talk about this subject on a national level. I can’t act like it’s not happening to me on a personal level as well. You see, I’m an editor of this blog...”

The Egg

I rarely write about health care and almost never discuss the war on women, because our “uniquely American” health care system has given me battle fatigue. Everyday it is some new insult. Last week, I was handed a list of over 90 medications the pharmaceutical industry is withholding in order to drive the price of drugs higher. On the list are popular pain medications, almost all the nausea medications, life saving emergency drugs and cancer therapy drugs.

This week, at the direction of our new Bishop, Northern California will deny birth control to as many women as possible. Tubal ligation, even if future pregnancies endanger the life of the mother, will not be allowed in any of the Catholic hospitals.

Somehow, my small isolated burg has been caught up in a national health care battle over just who should have control of a woman’s body.

The Affordable Care Act guidelines already include a religious exemption. An institution which provides its employees with health benefits can qualify for it, if its major purpose is to employ and serve co-religionists — like a church. That’s not enough for the Catholic Church, which says (though possibly not in these words) that it doesn’t want to subsidize the shameful non-procreative sexing of its employees at affiliated hospitals, charities and universities, whether they agree with the Church about birth control or not. The United States Conference of Catholic Bishops are pushing for a far more expansive religious exemption.--Salon
Our small county of 135,000 people spread over 3,600 square miles supports three hospitals. Two are run by the Catholic Sisters of St. Joseph of Orange in Orange County.

The last secular hospital in the area is barely hanging on. Our hospital has waged an all out competitive war against the hospital so they can capture its market share. The last secular hospital in the area, Mad River Hospital, is located on the northern edge of the county and ill equipped to increase its volume substantially.

Other secular hospitals existed in the area in the past, but they were bought by the Catholic Church during last decades spending spree. The one to the south was bought in 1998. After the purchase, the Catholics closed the attached clinic for the sin of prescribing birth control. The threat to eliminate birth control options spurred enough controversy back then to beget a bill in the local assembly requiring the hospital to contract with another institution to provided the needed services. Unfortunately, the bill was voted down.

When new seismic safety standards forced St. Joseph Hospital to renovate in 2000, the Church bought the other secular hospital in the area. They needed a place to treat patients while their hospital was under construction. Now, the old hospital is relegated to offices and outpatient services like lab.

In the late 1990’s the Catholic Church bought and merged with quite a few hospitals, resulting in 611 Catholic Hospitals in 60 health care systems in America, caring for half a million patients—12% of the nation’s health care. Catholic Directives to these hospitals come down from local Bishops.

                       

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A hospital acquired by the Catholic Church can no longer provide contraception, abortion, sterilization, and in vitro fertilization. Only 28% of Catholic hospitals said they would provide women who had been raped or trafficked emergency contraception through their ER.

Old Men in Skirts and Womens HealthIn a poll, 68% of women were opposed to a Catholic Hospital merger if it meant reproductive services would be curtailed. That same poll indicated 75% of women were opposed to Catholic health care imposing these restrictions on women if they took tax payer money.

All hospitals are funded by tax payer money—largely Medicare and Medicaid. Yet, the Church specifically denies women reproductive rights regardless of who pays for the services or the religious beliefs of the woman in question. St. Joseph does not even allow its non-Catholic employees to purchase health insurance that covers birth control.

Only 20% of Humboldt county are practicing Catholicism. Most women facing these restrictions do not recognize the authority of the Bishop to make such a decision for them. In fact, 98% of Catholics in America use birth control. For many rural women, a Catholic hospital is the only one in the local area. For the poor, without adequate transportation, getting care from a distant secular hospital is impossible. The Bishop is preventing me, a non-Catholic, from preforming tubal ligation on other women who are not Catholic, because he is allowed to own the only operating room in town.

When St. Joseph ran short of funds to complete their seismic renovations, they asked the community to donate money. The community of Humboldt obliged, giving $12.5 million. Over half of the population in the county is women, but when the time comes to move into the new 100,000 square foot, 3 floor facility, the only major branch of the hospital that won’t be going will be Labor and Delivery. When one of our nurses asked how the hospital could take community support from women, but then refuse to provide services for half of the members of the community, she was told by the CEO of the hospital, that Obstetrics was lucky to get room in the old building. The Board had considered closing Obstetrics all together, and using the space for rehabilitation.

Think about that for a second. Pharmaceutical companies can withhold life saving medications to drive up cost. The Catholic Church has the power to deny an entire county of women contraception AND the ability to deliver children in a safe environment. And they both have the will and the ability to use their power against my community. We are quite literally being held hostage by actors in the health care arena who are motivated by any thing but keeping people healthy. For insurance companies and Big Pharma it is profits. For Catholics it is control of women’s bodies.

The Sperm

Contraception by Jenny van SommersBeing female is a preexisting condition. Right now women are charged 15-30% more for health insurance then men. In addition, these policies actually excluded the benefits women specifically needed: contraception and obstetrics. During one survey of insurance, it was discovered that 90% of insurers covered Viagra and only 20% covered contraception. Even now, many insurance providers are telling women in my area they cover Intra Uterine Devices when the truth is they pay me less than it costs to purchase one, let alone insert it. They let me take the blame for not being able to afford to subsidize birth control for hundreds of women.

Women make up the majority on Medicare and Medicaid. They are more likely to be under insured or uninsured due to poor insurance in most jobs women do. These health care systems have a long history of being unfair to women. Medicare pays Gynecology about a third of what it pays Urology to do similar procedures on women than men.

Birth control itself has become a weapon in California. The state “insures” a enormous number of indigent women, telling them they have health insurance. In truth, the California program ONLY covers Pap smears and birth control. Women come to me for a number of complaints and I can only draw labs or work them up if they pay out of pocket. I have to explain that even if I think that huge mass on her face is cancer, her state “insurance” won’t pay for a biopsy. In essence, it is a state-run Eugenics program leveled against poor women.

There has been no controversy about Viagra—it is covered almost universally, including by Catholic institutions. For a while, Medicare even covered Viagra while denying prescriptions for vaginal estrogen cream.

The Republican run Congress has been incredibly misogynist on this issue. Their hearing on the matter was almost comedy. Exclusively run by men, and all but two of the witnesses testifying were male.

So what did Maloney have to say about the lack of uteri in the contraception hearings, just moments before she walked out of the proceedings with fellow awesome person Delegate Eleanor Holmes Norton?

   

“What I want to know is, where are the women? I look at this panel, and I don’t see one single individual representing the tens of millions of women across the country who want and need insurance coverage for basic preventative health care services, including family planning.”--The Jane Dough

Not to be outdone by the laugh a minute Congress, women have mounted their own comedy campaign. A flurry of bills making it difficult to get Viagra and vasectomies have been purposed in various state legislatures. Even a bill to prevent a man from spilling sperm anywhere but inside a woman!
     

EVERY SPERM HAS A RIGHT (OKLAHOMA): To poke fun a “personhood” bill that give full rights to a zygote, state Sen. Constance Johnson (D) introduced an amendment that would also declare every sperm to be sacred. “However, any action in which a man ejaculates or otherwise deposits semen anywhere but in a woman’s vagina shall be interpreted and construed as an action against an unborn child,” her amendment stated.

    CHILDREN DENIED BIRTH BECAUSE OF VASECTOMIES (GEORGIA): State Rep. Yasmin Neal (D) introduced legislation that would limit vasectomies. “Thousands of children are deprived of birth in this state every year because of the lack of state regulation over vasectomies,” Neal explained. Her measure is in response to a bill that would ban abortions after 20 weeks on the grounds that a fetus can feel pain — a claim disputed by doctors.

    MORE HOOPS TO CLEAR FOR VIAGRA (OHIO): In response toGOP Running Mate: The Pill! Ohio’s so-called Heartbeat Bill, which would prevent abortions once a fetal heartbeat is detected, state Sen. Nina Turner (D) will introduce a bill that would make men jump through hoops, like a psychological screening,before they could obtain Viagra and similar drugs for erectile dysfunction. “All across the country, including in Ohio, I thought since men are certainly paying great attention to women’s health that we should definitely return the favor,” Turner said.

    RECTAL EXAMS FOR A VIAGRA PRESCRIPTIONS (VIRGINIA): To protest Virginia’s bill requiring women to receive an ultrasound before an abortion, state Sen. Janet Howell (D) attached an amendment to the bill that would have required men to receive a rectal exam and pass a cardiac stress test before doctors wrote them a prescription for erectile dysfunction medication. “We need some gender equity here,” Howell said. The Virginia Senate rejected her amendment, but both chambers passed the ultrasound requirement after clarifying that women would not be forced to undergo a transvaginal ultrasound.

    KNOW THE SIDE EFFECTS OF VIAGRA (ILLINOIS): State Rep. Kelly Cassidy (D) decided to push back against GOP attacks on women’s health byoffering an amendment that would require men to watch a “horrific video” about the side effects of Viagra before the received a prescription for the drug. His bill is in response to a measure requiring women to undergo an ultrasound before an abortion. “If we are going to do this, we need to do it in a way that is applied equally,” Cassidy said.

    PROTECT ALL SPERM (DELAWARE): Mocking the “personhood” measures, the town council in Wilmington, Delaware approved a satirical resolution “that asks state legislatures and U.S. Congress to enact laws that forbid men from destroying their semen.” The resolution notes that if lawmakers think a female egg has full rights, then they should say the same thing about sperm.

    --Think Progress

                       
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Republicans war on women - the female anatomy target zoneOnly in America could this happen. For decades, other countries have seen the error of allowing money and and markets to run their health care and they have moved away from that system. But not here in the US. We ignore all fact and reason, forcing our health care system into a state of permanent collapse. Now the government is on the verge of forcing women to purchase health insurance while allowing others to prevent women from obtaining health care services. How can we even dream of complying with that idea?

Many people have likened the Affordable Care Act to the Swiss Health Care system. That couldn’t be further from the truth. The Swiss do not allow their employers to pick health insurance for the employee, so the workers at St. Jo’s could get health insurance with birth control if they wanted. Though the Swiss system allows private insurance, the Swiss government laid down the law about what minimum benefits constitute “insurance” and defined what constitutes qualified health care. The Swiss also prevent insurers from making a profit on the basic health care plan (which is very extensive). The insurers can only make a profit on perks like guaranteeing a private room or providing coverage for alternative medicine. The American system shirks its responsibility to get tough with the powerful in the health care game, and only focuses on forcing the average citizen to purchase a product—a product that might or might not provide the real benefit of health care.

Republicans war on women - the female anatomy target zoneOur system is quite literally owned by people who have motives other than the health of the population and we are held hostage by those forces. Where else but in health care is it considered reasonable to provide necessary services for just half of the population based on sex? If the Catholic Health Care system is unable or unwilling to care for half of the population in the communities it serves, should it be allowed to continue these restrictions? Should we continue to be held hostage by insurance companies, pharmaceutical companies and Religious dogma we do not even subscribe to?

I might point out here that Single Payer insurance alone would not cure this ill. The government must take the same hard line with the powerful that it has taken with the meek.

Or the meek could balk at the government edicts. I might also point out that true Socialized Medicine, the type they have in England, would fix this problem. Socialized Medicine is also how the Indian Health Service, the Veterans Administration and the Active Duty Military are run. Those systems are owned by the American people. They are paid for by our tax dollars. They are ours to control.

The next round of bills to force a real health care solution into our nation might do well to include an attempt to open those hospitals for a buy-in by the American public. Those system would get a welcome influx of cash and the American people could have access to a national system already in place with a decent health care package.

The Campaign

teaball contraceptionIt’s no wonder women approached Obama about shoring up the gross inequities in the system. Now, it appears, Obama might cave to the pressure of the Catholic Church and leave women out in the cold again.

I agree with the majority of women in America. If a health care service is taking government funds, it should provide service for everyone. If an institution is incapable or unwilling to do so, it should be forced to sell its health care assets to the local communities. These hospitals should be cooperatively run and federal funds should be set aside to aid in the transition. At the very least, these institutions should be forced to contract out the needed services.

Many of you laughed at our April Fool’s image of angry women throwing contraceptives at the feet of the President. Now, I want us to do just that. I propose the Pelt the President with the Pill Campaign. Save your, or a friend’s, spent birth control containers and send them to your Congressional leadership and the White House with this letter:

Date

Name

Address (with Zip Code)

Contraception is health care. We demand access to affordable birth control for everyone. Providers that can not provide for 50% of their patients, should not get federal funds.

Signature

If you don’t have any spent pill containers, don’t fret—send a condom. They are still available at the grocery store—at least at the time of this posting. The point is to send some contraceptive device. Why send a contraceptive? Because emails are ineffective at getting attention. Mere letters are also ignored. But sending some symbol of your discontent gets attention.

If you find yourself in Humboldt county, come by my office. We are forbidden from throwing outdated birth control in the trash because it contaminates ground water. Until now, I didn’t know what to do with all those pills.Think contraception

Find your Representative

Find your Senator

President Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500

The Choice:

My husband greets me at the door with a chilled glass of white zin and a mushroom cheeseburger.

I smile and sip the wine. “Yeah, it was just that bad.”

“What did you find out?”

“We don’t know where the orders are coming from.”

“What's the Gynecology Department doing about it?”

“Apparently, the winning game plan is to hope the bishop kicks the bucket soon.”

He snorts and takes a bite of his burger. “What are you going to do about it?”

“The bishop isn’t the only one with strong feelings on this issue.”

“So you’re going to move your surgeries?”

“I already told them my cases are going to Mad River.”

“What did they say to that?”

“They were angry..afraid. They want me to keep my mouth shut about the tubal decision.”

“Powerful people seem to want you to keep your mouth shut all the time. You gonna do it this time?”

I push corn around on my plate.

“I see,” he says. “Your stunt with the TSA cost over three thousand. What’s this going to cost us?”

I look up from my plate. “If I have to leave St. Jo, at least Mad River is closer to the home.”

“Mad River isn’t very big, hardly more than a super clinic. Some of your patients won’t go.”

My bravado has fooled no one. “I know.”

He locks eyes with me. My shoulders tense and I prepare for the Principle over Practicality argument...again. A storm gathers in the silence between us, ready to hails down angry words we will both regret.

His hand extends across the table, palm open.

Stunned, I place my hand in his. His warmth soaks my fingers, draining away my tension.

“That's my girl,” he whispers.

 

Originally posted to Anti-Capitalist Meetup on Sun Apr 22, 2012 at 03:00 PM PDT.

Also republished by Feminism, Pro-Feminism, Womanism: Feminist Issues, Ideas, & Activism.

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Comment Preferences

  •  Fight the war (17+ / 0-)

    I don't know what one person can do. Especially against an organization as over the top as the Catholic Church. But nevertheless, keep up the fight. And I'll do my part to make sure that women are not treated like second class citizens, no matter how difficult that fight might be.

    From one small corner of the internet, I'm a 100% with you.

  •  Wow, The War On Women Gets Worse and Worse. (13+ / 0-)

    Based on your report, the women in entire counties, if not states, could be deprived of access to urgently needed medical procedures, not to mention contraception.

    Who in the state government regulates these hospitals?  Would it be possible to attack the licensing of hospitals who are depriving women of proper medical care?  Who approves the sale of hospitals to Catholic entities?

    Women should return the favor and declare war on the hospitals who refuse to provide them needed services by petitioning for a referendum to force all hospitals to provide basic services or lose their licenses to operate.

    This situation is positively deadly for thousands of women.  Talk about "death panels".

    Thanks TPau for bringing the events in your hospital to public attention, heaven knows yours is not the only area in which this happening.

    It most be impossibly hard for you, as a doctor, to work under such conditions. Hang in there, we need your strong voice!

    Convict Bush, Cheney and their torture cabal. Support universal health care,unions, WikiLeaks and Occupy Wall Street! Time for a totally new, democratic economic system. Turn the corporations into worker cooperatives!

    by Justina on Sun Apr 22, 2012 at 03:20:25 PM PDT

    •  Hospitals and the law... (11+ / 0-)

      Hospitals are a private business. They are inspected by many agencies including JCHO and CHS. Both agencies are very rigorous in their inspections. In the latest inspections the nurses were told they could not have any food or drink near the nurses stations for sanitation reasons--the reasoning beyond that gets pretty vague. Keep in mind these men and women do 12 hour shifts.

      The problem with dehydration has become so severe some nurses stations are now allowing nurses to keep their drinks in the employee restroom because that is not a patient care area. Yeah, you're thinking exactly what I'm thinking right now.

      There are also rules about where I can and can not wear scrubs and what I can wear under the scrubs, etc.

      But no rules about refusing a certain procedure based on religion or based on the fact that it is only offered to women and not to men.

      Also, hospitals can operate without these certifications but they can not get Medicare funds. I don't know any hospitals that could afford to operate without Medicare money so that is the force keeping them getting the inspections.

      De air is de air. What can be done?

      by TPau on Sun Apr 22, 2012 at 03:47:39 PM PDT

      [ Parent ]

      •  This is amazing and represents a grotesque (15+ / 0-)

        failure to not only guarantee provision of health care to women, but also a violation of their civil and human rights on the part of the Catholic Church owned and run hospitals.

        If this is general policy in these hospitals, I am thinking that a serious class action suit may be something that may be necessary; but people will need to prove collusion by the church and that this policy is deliberate and designed to do this ... one would expect some protection from the government on these type of human rights issues, but this seems to be something that is not only being done deliberately but being supported by legislators (thinking about the hearings on birth control here) to eliminate women's control over their reproductive rights replacing it with the doctrines of certain religious groups. This is yet another infringement of the separation of church and state, the fact that money is more important than civil and human rights, and again expresses the need for not only full public health care provision but provision that covers need not ideology.

        "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

        by NY brit expat on Sun Apr 22, 2012 at 04:00:24 PM PDT

        [ Parent ]

        •  Hubby mentioned a brilliant idea ... it may be (4+ / 0-)

          difficult to sue these swines in court. But how about trying to organise a nation-wide campaign on insurers to exert pressure to stop using these hospitals. If the insurers pull out, that will bankrupt them. That is a hard campaign but one that could be won w/o having to take religion to court (good luck on that). It is a very good idea ...

          "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

          by NY brit expat on Sun Apr 22, 2012 at 04:39:08 PM PDT

          [ Parent ]

          •  I'm not sure how that would work here... (4+ / 0-)

            The Catholic hospital is the only big one in the area. I thing the next one is about 60 or 70 miles away in another county.

            Insurance is offered by your employer. You don't get much choice. All the employers offer a different very minimal choice package. I'm not sure how you could organize a boycott.

            De air is de air. What can be done?

            by TPau on Sun Apr 22, 2012 at 04:44:20 PM PDT

            [ Parent ]

            •  You can put pressure on your employer (3+ / 0-)
              Recommended by:
              TPau, divineorder, Cassandra Waites

              to choose another insurer if what is provided is clearly insufficient for the needs of employees. A nation-wide campaign to force employers to choose insurers that provide coverage for women's health is something that could be possible. If hospitals start losing insurers they will need to change policy. Now, if the legislatures, on the other hand, manage to enable these religious owned employers to deny birth control, that would probably require a law suit. I agree, we seem to be caught between Scylla and Charybdis here and it is incredible that a religious group can do this as policy. I am more enamored of a class action suit. Hubby also lives in a country where health insurance is provided by taxation and there are laws to prevent this type of garbage. So, private health insurance here is rather different from the states and at times the stupidity of the situation in the states simply does not translate to a civilised society.

              "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

              by NY brit expat on Sun Apr 22, 2012 at 05:03:54 PM PDT

              [ Parent ]

              •  Yes, you just can't explain a system this stupid. (4+ / 0-)

                De air is de air. What can be done?

                by TPau on Sun Apr 22, 2012 at 05:17:48 PM PDT

                [ Parent ]

                •  he constantly tells me that what I am saying (3+ / 0-)
                  Recommended by:
                  TPau, divineorder, Cassandra Waites

                  cannot be correct and that I must have misunderstood. So, not only can I not explain it, but I get patronised when I try to do so. sigh ...

                  "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

                  by NY brit expat on Sun Apr 22, 2012 at 05:30:17 PM PDT

                  [ Parent ]

                  •  Tell him for me, yes it is that stupid... (5+ / 0-)

                    For nonAmericans reading the site:

                    The employer picks the health insurance but doesn't really care if you have it or not because the employee pays for the health insurance in most case now.

                    The hospital takes most but not all insurance so if you are hospitalized in a place that does not take your insurance (say on vacation) you're screwed. The hospital does not actually care--they will just bill you and send you to collections if you don't pay. Our Catholic hospital will send you within a month or two to collections. I can't really blame them because so few do pay, rural hospitals are almost going under all the time.

                    The very poor get state or federal assistance. This pays most of the time but not very much so doctors don't want to take it. Also of late they have found ways not to pay like saying the wrong box was checked on admission so the whole $60,000 admission is not valid and will not be paid (recent event at St. Jo) or because the patient has an infection that used to be hospital acquired until about 10 years ago, and now is in the community at large, the gov won't pay the bill for the whole admission. I could go on and on...

                    De air is de air. What can be done?

                    by TPau on Sun Apr 22, 2012 at 05:41:05 PM PDT

                    [ Parent ]

                    •  yep, told him all this ... he also got to see (5+ / 0-)

                      my mom's reaction when she pulled out her credit card to pay for an ER visit here and they told her she was covered and she refused to believe that I didn't pay anything and started to loudly insist on seeing the admin of the hospital so that I wouldn't be paying her bill. Also, he got to see an individual doctor that had nothing to do with her case coming into to her hospital room in Florida when she was dying and my telling them that if they dared to file a bill with medicare I would report them and asked for his name. He just simply cannot understand how bad the situation is. When I told him about your piece today, he was horrified. They could not pull this stuff anywhere else.

                      "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

                      by NY brit expat on Sun Apr 22, 2012 at 05:52:57 PM PDT

                      [ Parent ]

            •  You could do a partial boycott... (5+ / 0-)

              only on elective procedures. For one month. Just ask everyone to reschedule.

              Which is effectively what they are asking your patients who want tubals to do.... reschedule until .... never.

              Grrr! Makes me mad to hear all this!

      •  Are they ending vasectomies, too? (2+ / 0-)
        Recommended by:
        NY brit expat, TPau

        Or are men still allowed to choose to end their reproductive capacities?

  •  Tpau, I cannot thank you enough for this excellent (15+ / 0-)

    heartfelt diary full of first-hand information from a medical professional who is literally forced to experience the war on women in such a direct manner. We have read so much on it, we have discussed what is happening in general, but to have such a first-hand description and discussion is priceless. Our lives and choices seem to be meaningless in the greater context of the realpolitik of Washington DC. The fact that the Catholic Church is deliberately sabotaging women's choices and healthcare (and also slapping down Nuns that refuse their position) is horrifying. On the political front, we are told our work is not worth equal pay by Wisconsin's governor. Our access to reproductive choice is being deliberately sabotaged. Our health is being endangered. We need universal health care and instead we get forced health insurance in which certain employers may be allowed to make choices for us on reproductive issues. Thank you for your excellent work, description, and for taking the right side once again!

    "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

    by NY brit expat on Sun Apr 22, 2012 at 03:25:48 PM PDT

  •  Anti-capitalist meet-up diary schedule (6+ / 0-)

    Hi comrades, we need to start setting up the schedule for the next 3 months and were wondering if anyone has a diary that they can do or an idea that they want to write about or expand into a diary. We really have a great series and in many senses we are really one of the few voices for the hard left on the daily kos. So, if you have a diary that you want to write, we have many open dates for you to write it. In fact, we are almost totally open. So, please let us know if you can do one. The series relies upon the participation of members across political lines here to get out ideas and discussions, so if you can do a diary, we need your assistance to keep the series going. Please let us know here, write to the group at dkos, write to TPau, NY Brit Expat, Justina or Geminijen, or write to our group email: dkanticapitalistgroup@gmail.com

    The schedule so far is:

    April:
    29: free jazz at high noon
    May 1: publish something to celebrate May 1st (International Workers Day) in the Anti-capitalist chat

    May:
    6:
    13:
    20:
    27:

    June:
    3:
    10:
    17:
    24: Isabelle Hayes

    July:
    1:
    8:
    15:
    22:
    29:

    "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

    by NY brit expat on Sun Apr 22, 2012 at 03:40:28 PM PDT

  •  Great diary. Surprise this hasn't gotten attention (12+ / 0-)

    This is American Taliban like stuff, for real.

    I rarely write about health care and almost never discuss the war on women, because our “uniquely American” health care system has given me battle fatigue. Everyday it is some new insult. Last week, I was handed a list of over 90 medications the pharmaceutical industry is withholding in order to drive the price of drugs higher. On the list are popular pain medications, almost all the nausea medications, life saving emergency drugs and cancer therapy drugs.
    I am shocked there is a religious exclusion in the ACA adding to the problem as to why you pay more for drugs and this of course this women the most, including my mother.
    • Myth 4: The ACA begins to solve our prescription drug cartel from bankrupting the sick.

      The truth: Anyone spouting this is spouting garbage and should be ashamed of themselves. I know this personally from what my Mom spends her money on. Not only that, I have the aggregate data so you don’t have to rely on my anecdote alone. The reason drugs are so expensive in this country is because of data exclusivity and patents.  I’ll refer you to the data from “got it right unlike Obama’s Rubinites” economist Dean Baker in his free online book:

      The End of Loser Liberalism: Making Markets Progressive (PDF)

      Patents and copyrights are both explicit government policies to promote innovation and creative work. They reward inventors, musicians, writers and other creative workers with government-enforced monopolies for set periods of time, and these monopolies allow the holders to charge prices far above the free-market price. For example, the nation will spend close to $300 billion in 2011 on prescription drugs.2 In the absence of government-enforced patent monopolies, the same drugs would cost around $30 billion, an amount that implies a transfer to the pharmaceutical industry of close to $270 billion a year, or about 1.8 percent of gross domestic product. It is close to 15 times current federal spending on the main government welfare program, Temporary Assistance for Needy Families (TANF), and it dwarfs the money at stake from a main goal of progressives: eliminating the Bush tax cuts for the wealthy (Figure 1-1).
      Obama’s deal with big pharma lobbyist Billy Tauzin(whom he derided on the campaign) prevented reimportation of drugs from Canada which Byron Dorgan tried to make a reality with his amendment ending this practice which dwarfs even ending the Bush tax cuts(which Obama didn’t do though all he had to do is nothing). Therefore we are transferring 1.8% of GDP to the big pharma cartel while I have to sit here and listen to lies about how the ACA is putting big pharma in check. Seniors on Medicare get slight relief from the donut hole in Medicare Part D but as you can see that’s not really putting much of a dent in the problem overall.

    This is scary stuff. I guess the Catholic league still has the power to put women down which is disgusting and disgraceful. Both parties should be ashamed of enabling, this, and the Republicanism for championing this.

    Disgusting antiwoman BS.

    Thank you for the diary.

    Pro Life??? Conservatives want live babies so they can raise them to be dead soldiers! - George Carlin - ROUND 2: Vote! Send me to Netroots Nation!

    by priceman on Sun Apr 22, 2012 at 04:00:50 PM PDT

  •  It think that the Church is still in the (11+ / 0-)

    midst of its pedophilia scandal and is being sued by many, many victims.  It seems appropriate to me to satisfy the inevitable judgments against the Church by selling a bunch of those hospitals.

    P.S.  If you're Catholic and still go to church, leave a note in your collection envelope saying you won't be making any more donations because [reason of your choice].

    We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

    by Observerinvancouver on Sun Apr 22, 2012 at 04:20:43 PM PDT

  •  i wish (6+ / 0-)

    The Catholic Church would just hurry up and die, or go bankrupt, whatever.
    A graduate student friend of mine got tired of his evangelical church upbringing so he and his wife started "shopping around" for a new church to attend.  They settled on the Catholic Church, which just blew my mind.  I mean, if you get tired of a church due to its doctrinal failings, why would you go to the church that invented doctrinal failing?  
    A former Nazi runs the Catholic Church now.  The Catholic Church condoned/s genocide worldwide.  Remind me again why they have any moral authority whatsoever?

  •  Watch That Last Video: Hilarious (8+ / 0-)

    If men had babies, abortion and birth control would be holy sacraments.  As it is, "Every Sperm is Sacred", as the video demonstrates with great humor, music and even dancing.

    Convict Bush, Cheney and their torture cabal. Support universal health care,unions, WikiLeaks and Occupy Wall Street! Time for a totally new, democratic economic system. Turn the corporations into worker cooperatives!

    by Justina on Sun Apr 22, 2012 at 04:39:32 PM PDT

  •  Stunning. (10+ / 0-)

    This diary is one of the best I've read on D Kos. I may gripe about the NHS in Britain occasionally, but the level of coercion experienced by obstetricians where you currently work beggars belief, even in terms of what was extant in Texas six years ago. I am in awe of the level of courage necessary to practice your field of medicine, which should by all rights, be one of the foundations of health care worldwide.

    "There's a crack in everything; that's how the light gets in". Leonard Cohen

    by northsylvania on Sun Apr 22, 2012 at 04:43:46 PM PDT

  •  As a recovering catholic, (6+ / 0-)

    it seems to me that the catholic church fits the very definition of evil that was lectured in the teachings of parochial school.

    The hierarchy is filled with MEN who support the rape of children, treat women like livestock, and use the gold from collection plates to wield their power against the masses.

    Woe to all of us if their power is not curtailed.

  •  This American Life... (4+ / 0-)
    Recommended by:
    NY brit expat, 4mygirls, cai, geomoo

    I'm listening to This American Life. Guess what the topic is:

    1. Someone who has to be right.
    2. Blogging.
    3. Catholics

    The irony in my life will never cease.

    De air is de air. What can be done?

    by TPau on Sun Apr 22, 2012 at 04:59:16 PM PDT

  •  patriachy is an evil (6+ / 0-)

    nothing demonstrates this better than this diary.

    that young women are ignorant of all of this seems incredible, yet what is obscured is far more than what is revealed all across the board.

    the catholic church scares me on so many levels.

    survival of this planet depends on reducing the human population.  fat chance with the catholic church insisting on remaining medieval far into the future.

    sigh.

    Donate to Occupy Wall Street here: http://nycga.cc/donate/

    by BlueDragon on Sun Apr 22, 2012 at 04:59:32 PM PDT

    •  It does seem that the world is out of balance... (8+ / 0-)

      The two sexes need to share power. One sex over the other, is bad for both the dominant and the submissive group.

      De air is de air. What can be done?

      by TPau on Sun Apr 22, 2012 at 05:13:20 PM PDT

      [ Parent ]

      •  and the "submissives" whom I prefer to think (6+ / 0-)

        of as exploited and oppressed are getting really tired of it as well. I cannot imagine that even the most voluntarily oppressed, reserved and submissive women are thrilled with the attack on their access to birth control, reproductive choices, and to be told that their work is worth less than a man for the same job. The vast majority of women will have used some form of birth control over their lives, they have the right to choose whether or not to have more children and their incomes are not pin money, they are essential for the support of their households since incomes of the majority are being cut all over the advanced capitalist world.

        "Hegel noticed somewhere that all great world history facts and people so to speak twice occur. He forgot to add: the one time as tragedy, the other time as farce" Karl Marx, The Eighteenth Brumaire of Louis Bonaparte .

        by NY brit expat on Sun Apr 22, 2012 at 06:06:46 PM PDT

        [ Parent ]

  •  Astounding, upsetting, well-written, (3+ / 0-)
    Recommended by:
    NY brit expat, Justina, geomoo

    kudos!

  •  I roundly applaud the dairy and the diarist (6+ / 0-)

    Most physicians would not take the stand you do. They would just sit in the Hospital lounge and rail about 'Obamacare'.

    Kind of gives me hope

    An empty head is not really empty; it is stuffed with rubbish. Hence the difficulty of forcing anything into an empty head. -- Eric Hoffer

    by MichiganChet on Sun Apr 22, 2012 at 06:26:36 PM PDT

    •  It gives me hope when I see someone new on the... (5+ / 0-)

      site. Thank you for the lovely compliment.

      De air is de air. What can be done?

      by TPau on Sun Apr 22, 2012 at 06:30:52 PM PDT

      [ Parent ]

      •  You are welcome. The site provides some good (3+ / 0-)
        Recommended by:
        TPau, Justina, BlueDragon

        food for thought. I wouldn't consider myself an anti-capitalist, exactly . . .I come to the issue of women's rights from a libertarian conviction, which for me means an upholding of the dignity and rights of the individual. . .plus for me it is also personal as I have a mother, sister, daughter and wife whom I would not see exploited by any religion or government. . but I am not blind to the many flaws and opportunities for exploitation the capitalist model enables, which affects, well, the dignity and rights of many individuals.

        An empty head is not really empty; it is stuffed with rubbish. Hence the difficulty of forcing anything into an empty head. -- Eric Hoffer

        by MichiganChet on Sun Apr 22, 2012 at 06:51:59 PM PDT

        [ Parent ]

        •  I do have a great deal of respect for our... (3+ / 0-)
          Recommended by:
          MichiganChet, BlueDragon, geomoo

          libertarian roots. (Born in Michigan and spent many years in Arizona). The Libertarians often have some very good points to make--particularly when it comes to limits and government. And about out monetary system in general.

          I am a little concern, though, about the ultra free market version of Libertarianism I've seen coming up in America. It seems a little "every man for himself" in its mentality and I don't think that is what Libertarianism is about.

          We should respect individual freedoms. Men are as effected by this issue as women. But health care is at its root about helping people less fortunate. Being a good neighbor is not anti-libertarian. I would like to see that idea put back in the rhetoric for Libertarianism again.

          Wondering if you get the same sense of the political landscape?

          De air is de air. What can be done?

          by TPau on Sun Apr 22, 2012 at 07:05:08 PM PDT

          [ Parent ]

          •  Yes, very much so (0+ / 0-)

            But first, I must disagree with you that libertarianism has intrinsically good points to make about our monetary system in general. The tight management of a country and its currency and monetary system is an absolutely indispensible function of a modern government; we can have a lively debate about how well that has been done in past and present, but beware the libertarian- money linkage. that way lies Ron Paul and general nuttiness. In terms however of limiting a government in its encroachment of individual rights - i.e the right of a woman to any damn thing she pleases with her body and reproductive organs, I do not know how one makes a better defense of this than using libertarian arguments.
               However when it comes to health care - or monetary policy for that matter - or defense or promotion of the general welfare, it is there that an unvarnished libertarianism falls silent. It is thus for the enlightened libertarians to admit that their philosophy has real limts and either expand them - which you seem to indicate can be done, and certainly any thinking individual can decide for him or herself what the boundaries of their new enlightened libertarianism really are, or just admit that there are limits and thus another philosophy that is more encompassing, such as progressivism is in fact called for.

               You are correct, today's political climate seems addicted to this simpleminded 'ultra free-market' version that acknowledges neither the real limits of philosophic laissez-faire or its consequences. And this is very harmful, because it has never been clear to me why it isn't blindingly obvious to everyone that the more the free market is given reign, the more social protection is required, something along the lines of why we let basketball players play in shorts and a tank top, but outfit football players in heavy pads and helmets. But then again, there is much that seems obvious to me and yet not to a lot of other people.

               Overall it is much more the inability of people to acknowledge limits, inevitable tradeoffs and failure to appreciate nuance that gives us disasters like our current heath care system. You are correct in that an enlightened libertarianism would recognize that everyone benefits when society as a whole is healthy. But when you actually talk to most 'libertarians' today - mostly of the Ron paul type it would seem - enlightenment seems the furthest thing from their quite limited intellects

            An empty head is not really empty; it is stuffed with rubbish. Hence the difficulty of forcing anything into an empty head. -- Eric Hoffer

            by MichiganChet on Mon Apr 23, 2012 at 11:25:48 AM PDT

            [ Parent ]

  •  Epic diary. Gah. (5+ / 0-)

    Please take care of yourself.  

    In the face of all this challenge, here's hoping you can keep your vision for a better world....

    Photobucket

  •  Because of Doctors like you, my mother is alive... (6+ / 0-)

    Back in 1975 my mom was rushed to the hospital by her OB. The baby she had been carrying for five months was dying, the umbilical cord pulled mostly loose. It had already begun to rot, had lost both arms and legs but was still alive. It was a bad situation all around, my mother was really sick, went into a coma from the sepsis. (I was five I don't remember all the details.)
    The problem was, the hospital was a catholic hospital and refused to abort the baby (finish the miscarry in this case) and save her life. There was a minute chance the baby would survive, of course, being poisoned for another four months, and without arms or legs so likely very very disabled as well, there was a lesser chance my mother would survive it.
    Her OB yanked her out of that hospital after a discussion with my father and sent her to Community General. The Doctor did not have practicing rights at that hospital, but it was the only way to save my mother's life.
    Because of that doctor I grew up with a loving mother and not just an alcoholic abusive father. Because of that doctor I have two younger siblings who were born after that incident. Because of that doctor my kids have a Grandmother. I shudder to think what my life would have been like without my mother.
    So from the thousands of other kids like me, I say, thank you for sticking to what you believe and standing up for the mothers who wouldn't live without you.

    "Madness! Total and complete madness! This never would've happened if the humans hadn't started fighting one another!" Londo Mollari

    by FloridaSNMOM on Mon Apr 23, 2012 at 08:26:53 AM PDT

  •  Great diary. So sorry I missed the discussion. (1+ / 0-)
    Recommended by:
    Lucy West

    A rare sign-in primarily to congratulate and thank the diarist.  As it happens, my daughter the ob/gyn was sobbing to me on the phone last night over a different issue but one that is also created by our insane for-profit "health" industry.  I sent her a link to this diary.

    She was upset because of the adversarial relationship our lack of health care creates between providers and impoverished clients.  She is being sued over a case that she has agonized over often, not because she thinks she made any mistakes, but because if she had been lucky, things would have gone a different way.  After delivering the baby who died soon after birth, my daughter walked into the waiting room and sobbed--she had been watching the signs of slow death signaled by the monitoring equipment.  It so happens that the family of the mother were in the waiting room and saw this display of emotion.  The next day, when she checked in with the patient, the mother asked her, "Are you okay?"

    This pregnant family was unusual in the population my daughter serves--they had tried to do everything right.  My daughter knew there was a potential for trouble as labor approached, and she had to make the best decisions she could.  She called the woman at home to check on her a couple of times, keeping up with developments and constantly reassessing the situation.  As it happened, admission to the hospital came about 4 hours too late.

    Her relationship with the family was strong.  They recognized that they had a doctor who cares.  This case so affected my daughter that she discussed it with me in detail, a rare occurrence.  This week, the lawsuit came in.  It claims that the mother wasn't informed about her dangers, it claims that no one checked on her at home, it makes several other inaccurate claims.  Probably because of the knowledge that my daughter did the best she could, she is not named specifically, which is unusual, but it will probably come down to her.  Now everything she scribbled in her notes matters.  She regrets not making a record of her lengthy discussions with the family over the best way to proceed--her warnings over how to minimize risk while waiting at home for labor to begin.  A couple of sentences here or there could make the difference between millions of dollars and a blotch on her record.  I relate all this to explain the effect this system has on health care.

    My daughter is so upset by this that she is wondering whether she will practice in Philadelphia, which is infamous for lawsuits.  The hospital is sued so often that the only thing that keeps them afloat is their extensive use of the cheap labor of residents.  My daughter sobbed that this makes her hate her patients.  She kept saying various versions of "I don't want to practice in a system that . . ."  One ending of that phrase was, "that refuses to accept that death of some babies is unavoidable while placing so little value on the life of the mother."  She will be devoting considerable time and energy to this case over the coming weeks.  It is likely that she will be practicing more with a fearful, self-protective attitude than the caring attitude that is her nature.  Every single resident at her hospital has been sued at least once, some several times.  It speaks to my daughter's diligence and close involvement with her patients that she has avoided it this long.  The population she serves is terribly impoverished, disenfranchised, and alienated from the system they must turn to for care to an even greater extent than middle class Americans.  The situation breeds dysfunction.  It is painful to see her idealistic commitment to serve this population of poor women so challenged.

    Oh well, there are so many problems that it is hardly worthwhile to examine the details.  Health care for profit is an obscene idea, a fundamental insult to human dignity.  That control of health care by a few puts women's health in the hands of male misogynists is but one more reason to get rid of it.

    I'm writing this in hopes the diarist sees it.  Stay strong.  Keep up the good work.  My daughter will be a chief resident in a couple of weeks.  She knows all the reasons for staying away from obstetrics, but she loves it and she's going to do it.  There are those coming up to keep fighting the battle.

    The Congress exists primarily to ensure the reelection of members of Congress. - Bacevich

    by geomoo on Mon Apr 23, 2012 at 01:32:35 PM PDT

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