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By Jimmy Carter

This article originally appeared in Mar. 3, 1997, edition of The Fort Worth Star-Telegraph.

Healthcare continues to be one of the most critical and volatile issues around. A little recognized aspect of the current health care "revolution" is the selling of religious hospitals - transactions that could, within the next decade, provide faith groups with between 15 and 30 billion dollars. This trend, which the June issue of Hospitals and Health Networks calls "the largest redeployment of charitable assets the country has ever seen," has begun impacting communities across the country.

Although some religious hospitals can compete with for-profit corporations, many are opting to sell their facilities because reduced profit margins make it difficult to serve those who cannot pay. When religious hospitals are purchased by for-profit companies, proceeds are often used to create sizable foundations that are required to continue the mission of the religious hospitals: to improve the health of those who are most vulnerable in our society. To accomplish this mission, foundations are working together to implement a new approach to health - one that focuses more on communities.

In March, Carterand InterHealth of St. Paul, an interfaith healthcare alliance, will bring together representatives of religious hospitals and foundations from across the nation. Our overall goal is to explore the role foundations can play in building healthy communities by using a public health approach, which stresses prevention and looks at whole populations, not just individual patients.

The need to emphasize prevention is a direct result of the health community having learned in recent years that negative lifestyle choices, such as smoking, eating poorly, and excessive drinking, cause most premature deaths (before age 65) in the United States. Foundations also have learned that addressing communities is necessary because lifestyle choices are often greatly influenced by marketing ploys of major profit-driven companies that target the masses. More and more, new religious health organizations are recognizing the power of such forces and designing ways to counter them - a new and somewhat daunting task for many of them.

Creating, implementing, and maintaining a public health approach to building health is a challenge for most foundations for two reasons. First, most leaders of these organizations come from a traditional hospital administration background - one that seeks to manage illness rather than prevent it. Many, therefore, are beginning to develop new analytical tools to approach health from a prevention-based perspective.

Second, the health of any community is strongly linked to choices made not only by individual residents, but also neighboring companies, civic groups, and other local organizations. Recognizing this, foundations are beginning to strengthen collaborations with leaders from a wide variety of backgrounds, including business, education, social services, theology, and medicine.

For at least 100 years, religious healthcare institutions have been partners with government. At the turn of the century, Catholics, Protestants, and Jews expressed their faith by constructing and operating hospitals to serve those who had nowhere else to go. In fact, many of the hospitals and healthcare institutions that have been most valuable to the poor, the elderly, and the vulnerable were built as a result of close collaboration between faith groups and government policy-makers.

Foundations can - and hopefully will - take the lead in maintaining this positive relationship between government and the medical field.

It is also important to remember that although 30 billion dollars in proceeds is substantial, it is a relatively small amount when compared to the vast sums generated by the business of healthcare overall - or the dollar amount the government is currently cutting from welfare programs alone. New foundations can make a difference, but they can not do it all.

In light of their deeply rooted and meaningful history, foundations have much to offer surrounding communities by incorporating the religious principles upon which they were founded into their mission and practices.

Together with partners in government and the private sector, they can start exploring ways of ensuring that the faith values that helped inspire and create this country's healthcare system remain an integral part of it.

Although our March meeting will not provide all the answers, it will give foundation decision-makers, hospital administrators, clergy, and community leaders an opportunity to develop a collaborative framework through which they can begin to make their goals a reality.