Catholic healthcare's new crisis: values versus bottom line.

Catholic healthcare faces its second crisis within the last 20 years and must focus on the twin challenges of survival without compromise and fidelity to Christian values to deal with it. The first crisis occurred from 1965 to 1975, when 150 Catholic hospitals closed or surrendered their identity because of fewer religious men and women to staff them and stricter government regulations. Since then Catholic healthcare has undergone renewal and rebirth: Religious institutes view the healing work as being responsive to the Church's contemporary needs, recruit staff and personnel who embrace the Gospel values, and emphasize the belief that social justice issues are at the heart of the Gospel message. The current crisis is the conflict between Christian values and a healthy bottom line. The fiscal solvency of healthcare facilities is threatened by a downturn in utilization, increased competition, reduced reimbursement, dwindling philanthropic support, and skyrocketing costs of medical services and technology. The challenge is to remain fiscally viable without compromising integrity. Several responses are possible, including broad participation by the laity and interinstitutional collaboration.