By Barb Arland-Fye
The Catholic Messenger is exploring the impact of health care on individuals, parishes, religious communities, businesses and other organizations in the Davenport Diocese.
For this story, we asked the leaders of the three religious communities based in the diocese — the Congregation of the Humility of Mary, Davenport; the Sisters of St. Francis, Clinton; and the Discalced Carmelite Nuns, Eldridge — about health care’s impact on their communities and their opinions about health care reform.
Concerns for all three ranged from keeping up with the constantly changing formularies in Medicare D prescription drug coverage to providing group health insurance and supportive living for aging Sisters.
“I have hit the ‘donut hole’ this year,” said Sister Mary Rehmann, CHM, the community’s president. She is referring to the coverage gap in the Medicare Part D plan where the Medicare beneficiary becomes fully responsible for medication costs. The coverage gap in 2009 starts when the retail cost of the medications reaches $2,700 and continues until the retail cost reaches $6,153.75, according to the Medicare Part D Web site.
Sr. Rehmann and Sister Johanna Rickl, the community’s vice president, also worry about the rising cost of providing group health insurance plans for Sisters and lay people who are not on Medicare. Premiums for group insurance for the community’s lay employees rose 13 percent this year and are projected to increase another 13 percent next year, said CHM Finance Director Bill Ganoe. The community has separate plans for Sisters and for the lay people it employs.
While the community has 133 vowed members, many are on Medicare and some are covered under employers’ plans. As a result, the Sisters’ group plan for those under 65 has shrunk to one participant. That Sister’s coverage could be absorbed in the lay group plan. But what happens if other Sisters would need group coverage in the future?
That concern is real for Sr. Rehmann. When she was between jobs some time ago she relied on COBRA, a program under federal law that enables a person to extend the group coverage of the individual’s most recent employer with the individual paying the full premium. While on COBRA, Sr. Rehmann learned she needed a hip replacement. Had she not utilized that stop-gap insurance plan, treatment of her hip problem would be considered a pre-existing condition and a new insurer would most likely not cover it.
More general concerns she and Sr. Rickl shared about healthcare focus on doctors not having enough time to talk with their patients, patients not wanting to impose health concerns on busy doctors, lack of communication between health care providers, older patients not being offered treatments based on age, and some Sisters’ reluctance to seek health care which is so costly that many people can’t afford it.
Sister Jan Cebula, president of the Sisters of St. Francis in Clinton, said her community’s concerns are the same as the general public: lack of coverage for all who need it. The Clinton Franciscans have about 70 vowed members, most who are on Medicare. Of those Sisters who are employed elsewhere and not on Medicare, “Some employers are not providing coverage, so we provide that ourselves.”
Like the Sisters of Humility, the Clinton Franciscans have separate group plans for Sisters and for lay employees. “We are a small employer so it makes it difficult for us to offer maybe the benefit choices that could happen if we were in a larger pool,” Sr. Cebula said.
Sister Mary Jo Loebig, OCD, sub-prioress of the Carmelite Monastery in Eldridge, said the community is insured through the Diocese of Davenport’s group health insurance plan — a big expense for the community of about $1,700 per month.
“I pray every time I write out a check, and it works,” Sr. Loebig says. The community has 10 members, nine who live at the monastery and one who lives at The Alverno Health Care Facility in Clinton. Five of the nine are on Medicare and four are on the diocesan group plan. In recent years, the community paid more than $2,000 per month in premiums. But as members come of age to receive Medicare the financial burden eases. “There is some benefit to aging,” Sister Lynne Elwinger, the community’s prioress, says with a smile.
Health care innovations
Asked what innovations they have undertaken to try to alleviate health care costs, each of the communities’ leaders spoke of efforts to enable members to live longer in their motherhouses.
The Humility of Mary Center offers supportive living, with nurses on staff and others who make sure Sisters get to various health-related appointments. A swimming pool and exercise room also are on site to help Sisters stay healthy longer.
Having Sisters live together longer “provides enrichment for us in community,” Sr. Rickl observed.
For Sisters whose health requires skilled care, there is the Bishop Drumm Retirement Center in Johnston, Iowa. The center added a skilled care wing some years ago as part of a collaborative effort of the Sisters of Mercy and the Sisters of Humility. About 20 Sisters of Humility currently reside there.
The Clinton Franciscans built their motherhouse, The Canticle, 12 years ago “to be more accommodating to the elderly, allowing them to live there longer and thus reducing our long-term care costs,” Sr. Cebula said. Sisters requiring skilled care live at The Alverno Health Care Facility in Clinton, which the Clinton Franciscans sponsor.
About 20 years ago, the Carmelite Monastery wondered how it would be able to provide for members requiring skilled nursing care. The Sisters placed a statue of St. Joseph looking out the window of the monastery and prayed for guidance. About that time, one of the Sisters entered The Alverno. That led to an agreement for Carmelite Sisters needing skilled care to reside at The Alverno. Sr. Loebig calls the agreement “an answer to prayer.”
The community also has made use of such public health services as hospice nursing care. One Sister was able to spend all but the last 10 days of her life at the Carmelite Monastery with the assistance of a hospice nurse and Sr. Elwinger, a former public health nurse. “That was a big help to me; I would certainly encourage people to use that service,” she said.
Ideas for health care reform
Leaders of the three religious communities have plenty to say about reforming the nation’s healthcare system, as well.
“Medicare is a real gift. Senior (citizens) ought to be advocating for universal care,” Sr. Rehmann said. She also thinks health care reform ought to prohibit discrimination by age. “The whole purpose of insurance is “to have a pool where the risk is spread,” she added.
Sr. Rickl believes a single-payer plan would be much easier to manage and would resolve errors that occur with codifying paperwork.
Sr. Elwinger would like to see an independent commission of knowledgeable people to serve as a think tank for health care reform. The commission ought to look at what other countries are doing with health care, she added.
Sr. Cebula would like to see the coverage gap resolved in Medicare D as well as the process by which medication rates are set.
“I’d like to convert our country back to being a society in which we care about one another. Right now health care is a commodity. I believe it’s a human right and that’s backed up by the U.S. bishops,” Sr. Rehmann said.
