Divine Intervention: Catholicism and Abortion in American/Canadian Healthcare

• In Event: Graduate Student Research Lightning Round: Identity, Public Opinion

Abstract

In the United States and Canada, the number of religiously affiliated hospitals is rising even as populations become less religious. The rise in Catholic hospitals has been particularly consequential because it is driven by mergers with secular institutions. The result is a decline in hospitals generally, as well as a decline in facilities willing to provide contraception and abortions. Existing theories of the countries’ health systems address the influence of unions, medical associations, insurers, and the insured, but have long neglected the role of religious organizations in shaping institutional configurations. This paper theorizes the Catholic Church's growing presence in healthcare as the result of partisan shifts during debates over contraception and abortion access in the 1960’s and 70’s. The Church sees its ministerial obligation to provide health services as requiring its support for universal care and its opposition to contraceptive access. I use primary sources to argue that abortion rights test bishops’ commitment to universal care, and that partisan strategies in the wake of this tension affects healthcare expansions. In the American case, parties kept abortion salient, so bishops were incentivized to obstruct healthcare expansions using contraceptive access as a wedge issue. While in the Canadian case, Catholics consolidated into a secular party, so bishops and partisans were incentivized to temper conflicts over abortion. Local bishops’ reactions to partisan cues inhibited healthcare expansions in the US, while encouraging them in Canada. But in both cases, their commitment to providing health services and blocking abortion access motivates them to protect their influence through hospital mergers and conscience protections. The Church’s commitment to providing care means that the persistence of private health insurance is the cause and effect of entrenching Catholic interests in the wake of abortion controversies. The analysis demonstrates that religion is an underexplored variable in developmental stories of American and Canadian healthcare; and reveals a tendency for health expansions to revolve around the availability of reproductive care.

Author

• Angela Kothe, Cornell University