Photo By Michael Alexander

ATLANTA—Catholic health care is being challenged by “divisions in the church” but what is needed is a more “humble and discerning approach,” said the leader of the Catholic Health Association.

The debate on how to balance religious freedom and medical care in a pluralistic society is not new. It goes back to the earliest days of the country, Sister Carol Keehan said.

The “freedom to serve” has been a “constant concern and source of vigilance” for Catholics since the Ursuline sisters in New Orleans opened the first privately owned Catholic hospital in 1728 in what would become the United States. A letter from President Thomas Jefferson in 1804 assured them the country would “never interfere with the commitments of their faith,” she said.

The current dispute surrounding the contraceptive mandate under the Affordable Care Act is part of this long-running history, she said, and the debate surrounding what is called “Obamacare” mirrors when Medicare became law in the mid-1960s.

In a 40-minute talk at Emory University, Sister Keehan, a member of the Daughters of Charity of St. Vincent de Paul and the CEO of the Catholic Health Association of the United States, outlined issues confronting medicine from a Catholic perspective.

Catholic institutions are one of the largest health care providers in the country, with more than 2,000 facilities. Nearly one out of every six medical patients is treated in a Catholic hospital; these facilities have nearly 800,000 workers and are often a community’s major employers, making Catholic hospitals a significant player in reforming health care.

Among the challenges facing Catholic health care is ensuring lay people moving into managerial positions are steeped in the mission of the religious congregations that started the facilities.

In the early 1960s, 770 religious sisters led hospitals; today there are four, she said.

This is a ministry of the church, not a business venture, so these facilities need to be treated with great care, she said.

On the Affordable Care Act, Sister Keehan said the law is as significant as Medicare and Medicaid, which also generated great controversy, including a threatened doctor strike. Today, it would be unimaginable not to have those two programs, she said.

The passage of the health care reform law wasn’t simple and it isn’t the law the CHA would have liked, but “it is the bill we could get passed,” she said. It has survived 33 attempts to gut it by lawmakers, a U.S. Supreme Court decision and a presidential election campaign, she said. And it will continue to be modified, she said.

On the contraceptive mandate controversy, Sister Keehan said her goal is to “dialogue this issue to resolution.”

“Substantial progress” has taken place, she asserted.

In the end, she said the CHA position is that Catholics institutions not be required to provide contraceptive services or pay for them.

“We will have no part in this,” she said. “The government can give you as a citizen whatever it wants, but we want to not have to pay for it, negotiate for it, or refer to it, or be held liable for it. We might regret the government is offering it, or finding a way to offer it to our employees, but the truth of the matter is, we are out of that loop.”

The deadline to comment on the latest government proposal is in April. The CHA hasn’t formally commented yet.

Some 400 people listened to her at Emory University’s Glenn Memorial Auditorium. The Aquinas Center for Theology hosted her for its annual Major Catholic Speakers Series. Sister Keehan’s service to the church was recognized by the Vatican with the awarding of the Pro Ecclesia et Pontifice medal (For the Church and Pontiff) by Pope Emeritus Benedict XVI. And in 2010, she was named by Time magazine one of the 100 most influential people. (Sister Keehan poked fun at that. She said other honorees included pop singer Lady Gaga and a few dictators.)

About the divisions in the church, Sister Keehan said bonds of faith should tie people together. The disputes are not on matters of faith, she said.

“Hopefully we can find a way to rejoice in our shared creed and our shared belief in the sacraments and have a more humble and discerning approach to other issues where we may not be in the exact same place on how they should be handled. But give the Holy Spirit time to enlighten us all,” she said.

In an interview before her talk, Sister Keenan said Catholics and people with other views must work hard to find mutual agreement.

“We are in a pluralistic society and that means sometimes you have to find ways that are respectful of different beliefs,” she said.

To talk about religious freedom requires Catholics to adhere to Gospel values, she said.

Sister Keehan said her organization holds to its principles firmly, but understands there may be different preferences in how the goals are achieved.

“When you talk about religious freedom in a pluralistic society you have to really work hard to be in a dialogue that talks about mutual respect and reasonable compromise. Compromise is not a dirty word. Compromise, per se, is not an intrinsic evil, although it has been made to be,” she said.

Health care for all is a key teaching for the church. It is rooted in belief in the human dignity of women and men, she said.

“You can’t live and grow well if you don’t have basic health care. The church teaching is very clear,” she said.

“We have 9 million children in this country who are uninsured. There is nothing pro-life about that,” she said.