A Discussion with Sr. Carol Keehan, President and Chief Executive Officer of the Catholic Health Association of the United States (CHA)

With: Carol Keehan

May 28, 2013

Background: Sr. Carol Keehan is the ninth president and chief executive officer of the Catholic Health Association of the United States (CHA), the umbrella organization for Catholic hospitals. A strong advocate of securing healthcare for all Americans, she has led CHA staff at offices in Washington, D.C. and St. Louis, Missouri since 2005, responsible for all association operations. Sr. Carol has held administrative and governance positions at hospitals sponsored by the Daughters of Charity for more than 35 years. She was the board chair of Ascension Health, Sacred Heart Health System in Pensacola, Florida and served for 15 years as president and chief executive officer of Providence Hospital, which includes Carroll Manor Nursing and Rehabilitation Center in Washington, D.C. She has held influential roles in the governance of various healthcare, insurance, and educational organizations including the International Federation of Catholic Healthcare Associations (AISAC) of the Pontifical Council for Pastoral Care of Health Care Workers. She is also a member of several health, labor, and domestic policy committees of the United States Conference of Catholic Bishops in Washington, D.C. and serves on the finance committee of the Archdiocese of Washington. Sr. Carol was a finalist for the 2013 Opus Prize awarded at Georgetown University in November 2013.

Can you tell us about your order, the Daughters of Charity?

The Daughters of Charity are not a religious community in a canon law sense. We were created in Paris in the 1600s. That was a time when the rules on the life religious women lived were very much oriented around being in the cloister and had we been founded as a religious community, we would not have been able to do the work we intended to do. St. Vincent de Paul and St. Louise de Marillac took on the task of helping the poor. It started first with what is now known as the Ladies of Charity. These were often wealthy women who visited the poor out of Christian charity. Because they were married and had family obligations, the next part of this effort evolved into a special order committed to the care of the poor. Under canon law, the Daughters of Charity are what is known as a society of apostolic life. We take vows for a year at a time. When we were founded, one of the early insights of St. Louise, our co-foundress, was that it would be advisable for us not to be under the authority of the bishop of a certain place, but rather to be under the authority of the superior general of the Congregation of the Mission (the Vincentian Fathers). We continue that structure currently. We are one of the largest communities of consecrated women in the world and our sisters have from the start been involved in healthcare, education, and social service.

From our very beginnings, we were dedicated to the service of the poor, following the example of Christ. St. Vincent and St. Louise both constantly talked about serving Christ and the poor. We have often been caught up in work that others were reluctant to do, especially at our beginnings, with galley slaves, orphans and unwed mothers, and people in the hovels of Paris. The first Daughter of Charity was Marguerite Naseau and she was an inspiration to those who followed her. Marguerite taught herself to read and then began to teach others. She also had a special interest in the care of the sick and actually died after bringing a sick and dying woman into her own home to care for her. 

While the Ladies of Charity were drawn largely from the wealthy women of Paris, the early Daughters of Charity were mostly poor women and not well educated. St. Vincent de Paul was very concerned that they not take on the trappings of a religious community and be considered by the Church to be religious. He often said to the sisters, "When the bishops ask you if you are religious, say, 'by God’s grace, I am not religious.'” St. Vincent was very sensitive to protect the sister’s ability to be able to go out into people’s homes and to the galley slaves to serve them. 

The sisters to this day look for opportunities to serve those most in need. I have the opportunity because of my work to visit our sisters in so many places in the world and they continue to take risks and find where there is pain and need. I have visited communities in Bethlehem, Jerusalem, Haifa, Beirut, Guatemala, and Switzerland to name a few, where I see such incredible work. One of the great works that our sisters do in Israel is with severely handicapped children. These are the most challenged of children and the sister’s devotion is remarkable. Their ability to reach out and care for children’s needs, whether they are Arab, Jew, or Christian, is so incredible.

The history of the community over 300 years marks its ethos and character. The order was suppressed during the time of the French Revolution but restored afterwards. The Mother House remains in Paris and has a special status in history. Part involved bringing the sisters back because of the important work they had been involved in such as schools and hospitals and care of the elderly; there was a marked gap when they were suppressed. The government worked with the community to restore our presence in France and some of the buildings including the Mother House. 

For me, the Daughters of Charity are a wonderful community whose ministry speaks to poverty and misfortune. We run hospitals that care for the sick with a special concern about those who cannot find care elsewhere. We also serve immigrant populations in many places. We are virtually present in all corners of the world. The programs that the sisters run are very creative in meeting the needs they find in each setting. One example that always impressed me was the nutritional centers our sisters run in parts of Central America. Many of the children in very poor families are severely malnourished and therefore constantly subject to infections and poor growth. The sisters often take these children for six months to a year in what are called nutritional centers where they can be fed properly and restored to health and then returned to their parents, able to resist infections. 

The order has a special history in the United States. The community was established by St. Elizabeth Ann Seton, initially in 1809 in Emmitsburg, Maryland. From the start, the Sulpician Fathers who staff Mt. Saint Mary Seminary and College in Emmitsburg, helped St. Elizabeth Ann in the formation of her community at the request of Archbishop Carroll. Because the Sulpicians knew the Daughters of Charity and the Vincentian Fathers in Paris, they had a copy of the rule that the Daughters of Charity followed and shared it with St. Elizabeth Ann. After the death of St. Elizabeth Ann and more political stability was restored in France, the possibility of uniting the two communities was pursued. Because by then the community was in many other places and working with many bishops, there was some resistance to being united with a French community. Understandably, bishops liked having “their sisters” in their ministries. While initially this was a painful family challenge for the community, it has resulted in six very strong communities who claim St. Elizabeth Ann as their foundress and work together wonderfully for the good of the Church in many places in the United States and other countries. It is a real sign that sometimes if a painful challenge can be dealt with well, it bears great fruit. We jokingly call each other cousins.

How many are there in the order?

About 19,000, and at the high point of vocations, there were almost 40,000 Daughters of Charity worldwide. There has been a decline in numbers, particularly in places like Europe and the United States. There are still vocations in the United States. While it probably will not ever return to the large numbers we had in the 1940s and 1950s, and we know that Catholic families today average about two children per family instead of the four to six we had in each Catholic family in the 1940s and 1950s. Not all of that is to be regretted. Lay people have the same call to live the Gospel, to grow in holiness and to care for others and they are becoming increasingly aware of it and encouraged in it by the Church. The result is that having fewer priests and sisters does not necessarily mean there will be fewer people to render the kind of care our baptismal calling demands of us.

Do you live in the community?

As with all the Daughters of Charity, I live in a small community of our sisters. We are linked to an institution that the sisters run. We are 11 sisters who live at the Elizabeth Seton High School in Bladensburg, Maryland. It is a great school with about 650 students who are a wonderful mix of Caucasian, African American, and Latino. Our community of sisters is very much a part of the school. Many of them, but not all, work at the school. There are also sisters like myself who do different work in the community but live in the school community.

The school community is very supportive of my work and sees the Catholic Health Association as part of a mission of serving the poor. I tend to race in, do my laundry, and move on. I try to participate whenever I can in the life and prayer of the community. The sisters go out of their way to make me feel part of the community. From the perspective of keeping up the house and taking on responsibilities, I am clearly the least valuable player, but I try to do what I can.

How has the order coped with changing times?

Take email as an example; the community has always grown with the signs of the times. It helps us to keep up with each other and to spread information about the community, its members and its needs. When we only had postal service, the Daughters of Charity among themselves used to find out which house got the letter with news in it first and we would call that house because we knew they would get the mail several days before the rest of us, and it was a great way to catch up on the news as quickly as we could. Now everybody gets the news at the same time and it is so much easier and less expensive to send out information, as well as pictures and other things. Even our elderly sisters, like one who is 95 years old, use email. We even vote on matters for the community with email at times.

How did you come to be where you are today? When did you think you would join the Daughters of Charity?

I was born at the old Providence Hospital in Washington, D.C. on Capitol Hill. It is a great facility; Abraham Lincoln signed its charter. My father was the son of first generation immigrants from Ireland and my mother’s family had a long history in Maryland, from the time of its founding. My father was in the Philippines during the war and we lived in southern Maryland. When he came home, we moved permanently to St. Mary’s County and I went to various Catholic schools there. Interestingly, in all of southern Maryland at the time, every Church was staffed by the Jesuits, and they were the only priests I knew until I was 18 and went to nursing school in Norfolk, Virginia.

After my first year at nursing school, I decided to join the Daughters of Charity. Within six days of joining, I was back at nursing school saying never again. But after finishing nursing school, I knew I wanted to be back with the sisters and that it would be wonderful.

After I finished my B.S. in nursing, I began work at St. Ann’s Infant and Maternity Home. I was there for six months and had the opportunity to work with very heroic mothers who were having their child and putting it up for adoption, as well as those who were going to keep their child. I also had the opportunity to care for children who had been deserted and abused and would probably at best find foster homes for them. Then when I was 26, I was sent to Pensacola, Florida to open a children’s hospital and I spent 10 wonderful years there. Neonatology was just beginning at the time and we were having an incredible opportunity to save the lives of babies who had never before had a chance to live and develop normally. It also gave us a chance to show at a very early stage in pregnancy that these were growing infants whose lives should be cherished. In addition, it gave me a lot of political experience. Trying to keep a children’s hospital open required coping with Florida politics and that was an incredible experience. We were able to create a great model in the hospital. There were private rooms for everyone, no matter who they were or whether they had any insurance. We had the chance to offer children of poor families great care as well as care for mothers who had no insurance. It was a tremendous opportunity because we were able to give the poor dignity and exceptionally good care. In fact, our work with OB and pediatrics caused the pediatric and obstetrical services that were very substandard at a county facility to close. 

The community then asked me to get a master’s degree. Because it was so important to understand finance well in order to be able to help people who were poor to get care, I did an executive education program in healthcare finance at the University of South Carolina. It was an excellent place to get a master’s in business, and although I expected to stay in Pensacola as I finished it, it was decided that I should go to Washington, D.C. as the vice president for nursing at Providence Hospital. I stayed there for five and a half years in that position. 

Then I was sent to be vice president for nursing and then the president/CEO of Sacred Heart Hospital in Cumberland, Maryland. I returned to Providence Hospital as the CEO a couple of years later and spent 15 years there. It was on the verge of bankruptcy but with everyone’s work, it was able to be stabilized. This was very important because of the service Providence continues to render in the District of Columbia. 

My next assignment took me back to Florida. I was asked to be chair of the board of the Sacred Heart health system there. Our sisters had been in Pensacola since 1915 and were no longer going to live there and we had never sponsored a hospital where we didn’t live. I lived in Mobile, Alabama with the Daughters of Charity there and commuted to Pensacola as board chair for a year.

While I was in Pensacola, I had served on the board of the Catholic Health Association (CHA). When the CHA president resigned, a number of people asked if I would consider the position. The Daughters of Charity council considered whether this would be a good role for a Daughter of Charity and informed me that they thought that it would; if I wished to apply they would be supportive. It seemed a good opportunity to have an impact on healthcare and Catholic healthcare in particular; a number of bishops I talked to also encouraged me to consider the position. I applied and after the search process, was chosen in October 2005. The CHA position has given me the possibility to help our members address healthcare issues that have been a concern throughout my 40 years in healthcare. 

Probably a little known fact about my time in healthcare is that, since 1980, I have been traveling back and forth to Japan teaching healthcare personnel there, nursing and administration, as well as risk management. I have also met them in places like Ireland and Hungary for seminars. This was the fruit of a relationship that began in the 1960s when a young Japanese nurse came to Providence right after finishing nursing school. She struggled with English and becoming a registered nurse in the United States, but persisted and became not only a registered nurse, but an excellent nurse manager. She had many contacts in the nursing community in Japan and after one of their visits, they asked if I would come to Japan to help them work on nursing management and governance of hospitals. It has been a great opportunity to see healthcare in another culture and system and meet many wonderful people.

Can you tell us about your focus on the issue of healthcare for those without?

I have been working in healthcare since I was 18 and have lived in or around a hospital for 40 years. During that time, I’ve seen so much suffering and what it does to patients, children, and their parents. When I ask where we are in the care of those in need, it takes me to the heart of the mission of the Daughters of Charity. Healthcare for those who are poor is the mission and focus of the healthcare component of the vocation of a Daughter of Charity. I know full well what happens when people who are poor get sick. I also know that the error of many of the assumptions and stereotypes we have about why people are poor and why they don’t have coverage. Most people who are poor work incredibly hard and many of them in positions where they wait on the rest of us. Without insurance, parents often don’t have the money to fill a prescription. I see the indignities that often go with presenting a Medicaid card and trying to get healthcare, whether it’s a doctor’s appointment or a special procedure. Many people forego physician care and preventive studies because they simply can’t afford the deductible or co-pay. We do have the ability and I think the national genius to get good care that is less expensive than what we have in our current system and that benefits everybody.

It is also a very pro-life position. There is nothing pro-life about having nine million children in this country who don’t have access to healthcare because they don’t have insurance. In the United States, we often see statistics that show abortions among women in general have gone down eight percent, but that they have gone up 18 percent in women who are poor. Knowing what we know about their lack of access to healthcare, it is not hard to understand why they feel they have no choice many times. We need to be a society that says we as individuals and as a culture value you and your child so much we will take care of you during your pregnancy and we will help you care for your child after birth. Really being pro-life means finding a way to get care for women and children. It is far more than condemning abortion or protesting. 

The situation with so many uninsured in our country is so unworthy of the greatness of our nation. We are a better people than that. Somehow in this fight, we have allowed people who are poor to be demonized. There are 48 million people in America, and nine million of them children who do not have access to healthcare. When I explain this to people at the Vatican and point out why it is so important to have vibrant Catholic healthcare in the United States, it is clear they simply cannot comprehend how that can be in a rich country like the United States. Justice and the Church’s social teaching compel us to address this problem.

Healthcare is a work of mercy and a great need in the lives of everyone. Keeping Catholic healthcare vibrant and true to its mission is very important. We need to be steadfast in the challenge to always have in the Church a dynamic healthcare ministry. 

How is CHA organized? How do you see its evolution?

CHA is a membership organization. Right now it has about 630 hospitals, although that number changes frequently. There are also some 1,400 other ministries. They include adult daycare, assisted living, nursing homes, surgical centers, and clinics, to mention a few. A number of our hospitals serve people in rural areas, but we are also very present in urban and suburban areas. It’s been estimated that Catholic hospitals treat about one of every six patients in hospitals in the United States. 

CHA is part of the dynamic change that goes on in healthcare and in our Church. In 1968, there were over 700 hospitals. Of those, most (all but 28) were led by women religious. Today, only three hospitals are headed by sisters. That is a massive change and involves a tremendous effort to insure that we have found ways to create formation programs that help lay people taking on these roles be equipped with the moral and social justice teachings of the Church, as well as the charisma of the founding community, so that they can govern and manage them as ministries of the Church. 

CHA has some role in supporting the management of our systems. Many of our hospitals have very good bond ratings, but some are also very challenged financially because of the large number of uninsured that they are committed to serving. Also healthcare has changed dramatically, even in the last 50 years. It has become far more high-tech, expensive, and challenging. We need to bring the competence in medicine, nursing, and finance required of today’s hospitals, as well as the mission-oriented components to maintain vibrant Catholic healthcare. 

The sisters began Catholic healthcare in this country at a time when very few women were involved in any kind of leadership in business and sisters were even less involved in activities in the marketplace. The sisters ran their hospitals as family businesses and even without experience and exposure to the business world, created the largest not-for-profit health system ever known. It is a remarkable story and a living legacy.

That brings us to an important part of the work of CHA and its members today. It’s helping to convey to new, generally lay leaders who are often Catholic but frequently not Catholic, what it is to run a hospital as a ministry of the Church, and helping them understand the moral and social justice teachings of the Church, how they enrich our ministry and how they impact everyday decisions. 

CHA is not a large organization. There are two offices, one in Washington and one in St. Louis, Missouri. CHA’s focus has grown over the years. We will be 100 years old in 2015. If you look at our early journals, we were from the beginning focused on sharing lots of helpful pieces of information such as different kinds of diet structures for the dietary department, staffing patterns for nurses, and other practical advice for departments of the hospital. Today the focus is rather different.

What is the balance between domestic and international work in CHA?

Most of our work is domestic. However, because most sponsorship was originally through religious communities who often had international programs, there is significant international effort by members. After studying this with our members, it was recommended that CHA take an organizing and coordinating role, and we have been doing this for about three years now. And some of the work began with the aid of a grant. One of our first projects was to work to develop a guide to a good medical donation program. We found in talking to the international sites that too often there was too much “junk for Jesus” being sent. It included supplies that could not be used in developing countries, outdated supplies and medications, and a number of other donations that were just not helpful. Despite all the goodwill, it was not good sense and yet the donation programs are so important. We are hopeful that the guide we have been able to develop with lots of input will be shared with not only our own systems but any healthcare organization that wants to be part of donating supplies to developing countries.

CHA cooperates with Catholic Relief Services (CRS) and I serve on the CRS board. Together we are rebuilding the St. Francis de Sales Hospital in Port-au-Prince, Haiti. Working in Haiti has been very challenging. The hospital is under construction and we are looking forward to a dedication hopefully in October 2014. This will be a tremendous benefit to the people of Haiti, both for healthcare and for education of physicians and nurses. It is very difficult to do this work because of the many challenges that people of Haiti face. We have been honored to have the opportunity to work with the Church in Haiti and with the physicians in charge of medical education. 

Can you discuss the recent struggles for healthcare reform?

This has been a very difficult but hope-filled time. It is important to remember that the Catholic Church has spoken for the need for healthcare for everyone since the time of President Theodore Roosevelt. The bishops were leaders in advocating for health insurance for everyone. All of our recent Popes have made it abundantly clear that society owes its members basic healthcare.

It has been very challenging at times to have the right kinds of dialogues and evaluations of healthcare programs. The conflicts among people of goodwill break my heart because we have to push forward as strongly as we can to get healthcare for everyone from the moment of conception until the moment of natural death. Some of the opposition to the Affordable Care Act, we believe, was simply based on information that was incorrect. 

CHA has been very clear from the start that a healthcare policy had to protect all our citizens through their lives. We made it very clear that we would not compromise on our principles but that we would compromise on preferences such as the best way to get it done. We are very happy that two federal judges have now ruled that there is no federal funding of abortion in the Affordable Care Act.

Have you felt negative consequences for your work because of the positions you have taken?

There have been some negative consequences and there have been an overwhelming number of negative comments, accusations, and newspaper articles. At one point, officials in the Vatican took me off a committee there and off as a speaker at a seminar. What happens to me is not what is important. What is important is what happens to the 48 million people who don’t have access to healthcare. 

I love the Church and have worked in it for almost 50 years. I also know the Gospel and the teachings of the Church and could not see the chance for the poor to get healthcare be lost again. I was especially committed to getting this done because I knew exactly what the language was and how it not only excluded any federal funding for abortion, but had programs that were well-funded to help the most vulnerable women who were pregnant. The fighting has been a bit crazy at times, but my great hope is that we will continue to work it through and that at some point we may see some great good come out of even the misunderstandings. 

A number of bishops have been very supportive and CHA has worked to have a strong relationship with the U.S. Conference of Catholic Bishops. We need to be very careful as members of the Church that we do not allow others to pit us against each other and tear down the unity of the Church. CHA has been very clear that the bishops are the moral teachers, and we have absolutely no difference of opinion with them on the evil of abortion and its acceptability as part of a national health plan. We did work closely with the members of the House and Senate, as well as the executive branch to make sure the language would protect that principle.

How do you think health reform will work at this stage?

On the one hand, looking at the preparation that’s going on for opening the exchanges has been very impressive. I look at the work being done in places like California and Maryland where they are fully embracing the opportunities that are in the bill for the people of their states. They are doing great work and they are going to be offering as many as 30 plans in the exchange. Clearly it will be very difficult to get this started; there will be bumps in the road and glitches we didn’t expect, but that’s all they are. They are not a reason to abandon such an important objective. On the other hand, at times looking out at health reform efforts has been frustrating because some states are simply for political reasons refusing to expand their Medicaid and/or refusing to take advantage of the opportunity to run their state exchanges and help give this coverage to their citizens. Sacrificing healthcare for the poor for political advantage is very contrary to the social justice teachings of the Catholic Church. 

The suffering can’t be exaggerated. We know the Institute of Medicine says we have 18,000 unnecessary deaths a year in this country because of a lack of access to healthcare coverage. The Church has long spoken out on the need for healthcare coverage for everyone. In addition, it impacts everything—economics, housing, outsourcing—and our nation’s economic structure will be greatly strengthened when these programs are fully implemented and we are not trying to cross-subsidize the cost of care for 48 million uninsured Americans who get their healthcare late and in the most expensive venues, primarily the emergency departments. We also know the pain to individual families financially. Studies show that over 50 percent of bankruptcies are due to health expenses and some studies demonstrate that four in 10 cancer survivors are bankrupt. 

The impact of this is on our most vulnerable, the ones that need it the most. The healthcare bill does work to fix that or at least make a big improvement in it. We need to remember that for insurance, it is the policyholder, not the stockholder who should count. It is the policyholder who is vulnerable with illness. One of the great things the new system will do is insure there are no lifetime limits on coverage, no pre-existing conditions, and mental health will have broader coverage. Very importantly, insurance companies must now spend 80 to 85 percent of the healthcare premium they charge for healthcare. 

The exchanges offer great promise, particularly to small businesses. They will now be able to buy insurance for their employees at reasonable costs and in many instances, get a tax credit and their employees will get a subsidy. This is a huge gain that will strengthen small businesses and help the people they employ. 

The really frustrating part is to see states, for political reasons, simply refuse to participate and leave so many people uninsured when they could get care. The dishonest statements that are made about how much it would cost states to do this and why they can’t do it have been debunked fairly effectively by studies, most especially the Kaiser Family Foundation study. It clearly pointed out that states like Florida would not lose money, but would make money because of the Medicaid expansion. It does mean we have to keep up the effort to change the minds of the governors and the legislators in some states to get the Medicaid expansion and state exchanges fully operable and to break down the artificial barriers that some states are setting up in regard to enrollment.

Getting these exchanges set up, making sure they are user-friendly and getting people into them will take work and cooperation. We know that 70 to 80 percent of the people who are eligible for this new coverage don’t know that they are eligible or actively think it will not help them. That is a real challenge.

Another extraordinary thing is that many still don’t believe the bill has passed. We need to use every method we can find to communicate the facts. CHA has been a founding board member of Enroll America to help communicate and facilitate enrollment. We need to use every avenue we have to talk about healthcare, whether it is a sports venue, our churches, our tax preparers, the St. Vincent de Paul Society, Catholic Charities, community centers, and clinics. Every opportunity we have to communicate should be capitalized on. It is particularly frustrating, and I try not to be unreasonably irritated or angry, when people put obstacles in the way of getting coverage to people who need it so much. Particularly irritating is the fact that this is not only going to be good for those who don’t have health insurance, but everyone will benefit when we as a society are more fully covered with health insurance. Deliberately sabotaging this opportunity strikes me as outrageous.

You have one of the pens that President Obama used to sign the bill?

Yes, I do. It was very kind of the president to give me one as a thank you to the many people in Catholic healthcare who had worked so hard to make this bill a reality.

How do you see CHA’s role?

Healthcare reform is a long-term passion for me, going back way before the Hillary Clinton effort. Now CHA has an opportunity to provide some of the leadership required to get this fully implemented. I believe CHA has credibility and the experience to speak on how the bill does work and can work for the people who need it the most. 

How do you relate to various Catholic organizations active in healthcare?

We work very closely with CRS and they are a member of Caritas. As I said earlier, we are doing work with them to rebuild the hospital in Port-au-Prince. We also have worked with them in their international relief work through the tsunami and through the problems in Japan and other major disasters throughout the world. Catholic Medical Mission Board has a number of our members on its board and we have worked with them from time-to-time and look forward to expanding that work with them. 

We also work very closely with Catholic Charities USA in advocacy and programs that reach out to the vulnerable, particularly those programs which speak to healthcare needs. 

What’s the next great challenge for CHA?

CHA’s challenge is to make healthcare reform work as well as humanly possible and not to allow knee-jerk responses to lead to very bad decisions that undermine its effectiveness. We have an opportunity as Catholic healthcare to lead by example, to use the creativity and ingenuity we have shown since the beginning of Catholic healthcare. We can build on this bill and use it to transform the way healthcare is delivered. It is also important that we continue our effort to help lay people as they take the responsibility for the future of Catholic healthcare. They will have leadership roles in one of the most important ministries of the Church and they are and will continue to do it very well. We also need to think about and pay attention to the large looming issues that really are choices for the future. These will emerge from research and technology. Stem cell research is an example. A huge world will open up from stem cell research in the very near future. Stem cells that derive from the destruction of embryos are absolutely contrary to our moral teachings. However, there are many uses of stem cells that come from non-destructive and very positive research in this area. Catholic healthcare needs to be promoting that kind of research so that we are able to achieve all that it has the potential to do. 

We need to also deal with the issues of genomics and what that is going to mean for the future of healthcare. There are many ethical issues that surround research in the area of genomics and the Church’s wisdom and moral teachings can help healthcare and those it serves reap many benefits and hopefully avoid ethical pitfalls as we take advantage of things such as genome mapping. In these huge changes, it is important to have a faith-based perspective and it is our responsibility to make healthcare what it can be. Faith and life—that is what it means to subscribe to Catholic social teaching and the Gospel. Who of us would not want to promote our Church’s teaching that all should have healthcare in order to be able to find joy and to live life fully. We can no longer sit by and let the skewed way wealth has emerged from our recession continue. Our new Holy Father is telling us that we must be a voice for fairness and justice in the way the wealth of the earth is shared, and in our case a specific focus and expertise on healthcare. 

We know there are many issues where we cannot make as big an impact as we would like: the horrible conflicts in the Middle East, trafficking, 25,000 child brides a day. But there are many people for whom we can and should make a tremendous difference. We need to do all we can to impact life for those who at this point are so vulnerable. If we have a level of influence either with our neighbors, our government or anyone else, we should work to change minds and hearts so people will no longer tolerate these injustices. We do not know the future, but for CHA it will be critical to have programs where lay people are truly committed to the values we represent. Health is one of the Church’s most important ministries. 

CHA has many people today who understand the business of hospitals, but also understand what it means to be poor. It is important that we use our voice so that the poor have a voice in discussions because they are so often left out. It is important that we are willing to take a risk on behalf of those who are so at-risk today in our society. We understand at CHA the concerns the bishops have with many issues and we are supportive of them. However, when it comes to the mandate questions and advocating on behalf of for-profit businesses, that is not something CHA has an expertise in. We have worked to assure that our members running Catholic hospitals would not have to purchase, arrange for, or refer for contraceptive coverage. And that is our responsibility to our members and our contribution to resolving some of the concerns about the HHS mandate that the bishops had. 

We are very concerned to work as the Church helps to lead our culture into a new appreciation of the value of the life of mothers and their unborn children by the real intangible commitment it makes to helping women get the care, education, and support they need to carry their child and to support their child. There is so much that is in the Affordable Care Act that would help this, as well as the potential to get 30 million people enrolled, particularly those who work for small businesses.

Will you comment on the role of women in the Church and the controversy over the sisters?

I personally believe that this is unfolding. It was disheartening at first, but in many ways the pain of it all was transformed by the outpouring of support from so many Catholics and non-Catholics for the sisters. There are positive signals from the new Pope, who has talked about enhancing the role of women in the Church. He has also been the first to talk about one of the worst things: to deny people a decent wage. We have a responsibility to each other, to the immigrant, to the sick, to the handicapped; these are all the things that the sisters in the United States are known for repeating over and over again, and giving priority to. 

He is also living at St. Martha’s and the sisters do the cooking for him. He is a very gentle and caring man who appears to be treating those that need to move out of leadership positions with great dignity. He is unstinting in what he says about things that are horrible for the Church and that transparency and simplicity have endeared him to people all over the world. The sisters have worked hard to get through this process with dignity and integrity and I believe that for this Pope, the only agenda is advancing the Gospel mission and he can certainly be relied on to do that. Plus, he has a wonderful group of sisters in Leadership Conference of Women Religious (LCWR) to work with.

What about the nuns on the bus?

Sr. Simone is a good friend and a really wonderful person. She has done so much to raise awareness and speak out against injustice. She also was the first one to say after I issued the CHA statement in favor of the Affordable Care Act, that they should not leave us out there by ourselves. And NETWORK and LCWR immediately developed a paper in support of the Affordable Care Act. 

What has made you a leader in the fight for universal healthcare?

I think that I have had the opportunity and the grace to work with many, many people who were very sick but also had very limited means. When you have done that for decades and know that we are the richest country in the world and are not supporting them well enough, and in some cases our employment structures keep them poor, you have to have the courage to speak up. I also believe that a nation is greater when it takes care of all of its people and not just the top 5 percent. Hubert Humphrey said it well, that we would be judged by how we treated the most vulnerable, that is the youngest and the oldest. And there is a lot of wisdom to that. 

This nation has the genius to develop an exceptional healthcare system. There is a great need for common sense and the commitment to find the best way as certain reasonable accommodations or exemptions are made and as structures are developed and modified that will best serve our nation’s people. Even in our differences, we need to continue to dialogue together. I have studied the tensions that preceded the passage of Medicare and Medicaid in 1965. And in many ways, they almost seem worse than what we’re facing today. However, we have come through that and no one can think of not having Medicare as part of our protection of the senior citizens of this country. We need to remember that and keep working with courage and vision today for the good of everyone in this nation.

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