Another Shift in the Abortion Winds

There are times when the crises just keep comin’ atcha, when there’s scarcely time to think, what with all the mudslides and riots and quakes. And then there are times, even here, when the firestorms let up and the attention turns to more familiar embers. Times, in other words, like these.

Hence the sudden resurrection of certain long-running political battles, time-honored issues that, like an old campfire, will flare up if some fuel --any fuel--gets thrown their way. There’s gay marriage. There’s race. And, this week, abortion, in the guise of a nationally watched bill that’s scheduled to come before the state Assembly as early as today.

In busier times, AB 525 would be a snoozer. Authored by Assemblywomen Sheila Kuehl and Helen Thomson, it involves hospital mergers, a topic that makes me want a nap. Nevertheless, its thrust--access to reproductive health services--has put new fire into the endless fight between anti-abortion and abortion-rights advocates.

The gist is this: Though abortion rights in this state are fairly settled, legally and politically, the national battle has shifted from the partial-birth fight to a new, more corporate front: In town after town, including a few places in rural California, struggling community hospitals have been forced by managed care economics to merge with larger health systems and hospitals. And in town after town, the only takers have been big nonprofits run by the Catholic church.

Of course, a town can do worse than to have a Catholic hospital; their commitment to the poor, for instance, is well-known. But when the Catholics come in, so do certain, nonnegotiable tenets. Services like abortion--and often contraception, sterilization and fertility treatments--go out the door.

There’s no crisis yet, but concern is growing. Catholic health care systems are the nation’s fastest-growing nonprofit providers. Last year, eight of the 14 largest systems in the U.S. were Catholic. San Francisco-based Catholic Healthcare West is now the largest hospital chain in California. When CHW recently bought Unihealth America (talk about a nap-inducing headline), it had this upshot: Eight local hospitals stopped performing abortions. They were California Hospital Medical Center downtown, Glendale Memorial, La Palma Intercommunity, Long Beach Community, Martin Luther Hospital in Anaheim, San Gabriel Valley Medical Center and both locations of Northridge Hospital.

Carol Bayley, CHW’s director of ethics and justice education, says AB 525 is an overreaction. Most people go to clinics and doctors’ offices--not hospitals--for abortion and contraception. And even in places like Grass Valley, where the only local hospital is Catholic, the farthest non-Catholic facility is just 20 minutes away. She wonders, with good reason, whether the bill’s advocates are just exploiting California--using it as a staging area for a national campaign to maintain abortion rights in more rural states.

The bill’s advocates, meanwhile, wonder--also with good reason--whether the Catholics have a hidden agenda; the bill is, on its face, fairly mild. Among other things, it would inform consumers, strengthen the attorney general’s power to review nonprofit hospital sales and mergers, and force health plans to contract with at least one facility that provides full reproductive health services.

But it also would make state loans or bond programs contingent on a promise to make the full range of reproductive health services available. If a hospital wouldn’t, say, do abortions, it would have to promise to contract out for them.

In other words, the Catholics retort, hire a hit man.

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One quality of these long-running issues is that by the time they’ve burned down, neither side seems as noble as when the fight began. What thinking person by now isn’t ambivalent about abortion, or the system that condones it? Who (and I say this as a Catholic) can really approve of the church’s imperialism, or the disdain for women that runs through the anti-abortion camp?

For the ordinary non-fanatic, it’s exhausting--all this talk about spin and “stealth” threats to women’s rights. Meanwhile, the Catholic hospitals are running half-page ads signed by nuns, claiming that the bill “fans the flames of religious intolerance.” So much interest in who can claim the moral high ground. So little in the broader crisis of the managed care juggernaut.

Still, AB 525 is important, both for practical reasons and as a societal gut check. There’s a reason these issues smolder: They’re complex. Revisiting them, trial-and-error testing them with different measures of fuel, is as close as we can come, maybe, to resolution. Also, it passes the time until the firestorms come back.

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Shawn Hubler’s column appears Mondays and Thursdays. Her e-mail address is shawn.hubler@latimes.com.