Monday, December 1, 2008

Propaganda Hospitals Prepare to Close

The flurry of hospital layoffs and closings this year is likely to accelerate next month after President George Bush leaves office.

One of the cornerstones of the Bush presidency has been to convert health care spending to propaganda spending. This strategy of the Bush White House first came to light in 2001 when new rules prohibited AIDS education efforts, especially in Africa, from mentioning condoms as a way to limit the spread of HIV. But the White House rules for health care as propaganda also affect federal funding that goes to hospitals in the United States. How big is this propaganda money? Analysts expect as many as 1,000 hospitals across the United States to collapse next year when this special funding is withdrawn.

The assumption is that new president Barack Obama, who has never been a fan of propaganda, will return all the propaganda money to health care. This move will benefit hospitals whose focus is health care, but will pull the rug out from under those institutions for whom health care is a front for propaganda.

The era of lavish spending in the U.S. health care system was coming to a close in any case. The system is under pressure from:

  • newly health-conscious consumers losing interest in drugs and surgery
  • health care professionals rebelling against the many layers of paperwork
  • steady improvements in workplace, product, and highway safety, resulting in fewer injuries
  • declines in cigarette smoking, beer, and hard liquor, along with improvements in food quality, resulting in fewer illnesses
  • the big pharmaceutical companies’ shift of emphasis from research to marketing
  • profit-minded middlemen, especially insurers
  • cutbacks in consumer discretionary spending because of the economy

Many hospitals that have seen their business fall off have been able to keep going with federal money tied, in one way or another, to propaganda about sexual abstinence. These “propaganda hospitals” still provide real medical care, but the conflict of interest, when an institution depends on propaganda for essential funding, could only hurt the quality of care.

The Roman Catholic Church is likely to be hit hardest by the loss of the Bush propaganda money. The church is focusing on the Freedom of Choice Act, a bill expected to pass Congress in January and be signed by Obama as soon as he takes office, which would eliminate all the special funding that Catholic hospitals have been getting for not performing abortions.

The Roman Catholic Church takes its hospital funding so seriously that it has warned that anyone voting for the Freedom of Choice Act would be automatically excommunicated — formally kicked out of the church. It has also issued scattered statements suggesting that anyone who voted for Obama, as most U.S. Catholics who voted did, had committed a “grave sin” because of Obama’s opinions on health care funding.

Yet even without the Freedom of Choice Act, no one could expect the special funding that propaganda hospitals received under the Bush administration to continue. The Catholic bishops who have suggested that all 614 Catholic hospitals will close their doors are surely exaggerating, yet it is probably true that large numbers of hospitals will close. Already hospital closings are in the headlines almost every week. At least half of the 6,000 hospitals in the United States will have to close in the next 25 years because of declining demand and improvements in productivity. If several hundred or even a thousand propaganda hospitals close next year, it would be an inconvenience for the customers of those hospitals, but a benefit for the health care system as a whole. It would take some of the pressure off the more sincere parts of the health care system and allow the system to adjust more gracefully to changing market forces in the years ahead.