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In this article, Father Morrisey uses a legal approach to analyze the challenges facing Catholic healthcare in a time of rapid change, drawing his observations from his work with Catholic healthcare institutions both in Canada and in the United States.
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This notice amends the Public Health Service regulations on Federal qualification of health maintenance organizations [HMOs]. The purpose is to provide greater flexibility for already existing prepaid health care delivery systems to become transitionally qualified HMOs. Adoption of this amendment wil allow entities operating these systems to satisfy the requirement that basic health services be provided to members by demonstrating that members enrolled at the time of transitional qualification receive hospital services or are insured for hospital services through an arrangement not made by the HMO.
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Although hospitals have grown and prospered by "doing good," that purpose no longer is the only consideration in health care decisions. Business and the federal government now play key roles in controlling costs, and the once orderly prepayment industry is now a tangle of competitive interests. For the next few years, economic considerations will force quality-of-care issues to the background. In fact, until the current malpractice crisis, which causes physicians to practice defensive medicine, is resolved, it is unlikely that "doing good" will be the dominant concern. The future does not, however, hold greater and stiffer economic competition as far as one can see. Payers will be able to wring concessions from hospitals for only so long. When patient care is jeopardized, payers then will loosen the purse strings, and hospitals will return to a balance between "doing good" and "at what price".
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