Hiltzik: Major hospitals say they are fed up with Catholic health regulations

Published

5 years ago

May 20, 2020

Hiltzik: Major hospitals say they are fed up with Catholic health regulations

There may not be much reason for optimism in American health care now, but one hope arises in Orange County, California, where a prestigious hospital says it’s fed up with the Catholic Church’s restrictions on health care.

The Hoag Memorial Hospital in Newport Beach, which was established as a Presbyterian institution in 1952, demanded to break away from its partnership with the Catholic hospital system in 2012.

The agreement was controversial from the start, partly because Catholic partners imposed a ban on abortion on doctor Hoag even though they had been promised that the agreement would not have an impact on their practice.

Usually, in a hospital merger there are two sides to the negotiating table. When one of the partners is the Catholic system, there is a third party outside that has long-term influence – bishops.

Lois Uttley, MergerWatch

Now Hoag’s management has awakened, if it is too late, the effect on the patient.

“It is increasingly clear that Presbyterian beliefs, values and policies have been compromised because of restrictions in the larger Catholic system, and that these constraints impose on the correct implementation of Presbyterian beliefs, values and policies,” Hoag said in lawsuit aimed at dissolving the partnership with Providence Joseph Health, which manages 51 hospitals and hundreds of other medical facilities in seven western states.

The more stringent regulations enforced by Catholic bishops in affiliated hospitals, the lawsuit added, “signifies the possibility, if not the possibility, of growing gaps on key issues that also affect the delivery of care” by Hoag.

The lawsuit was filed May 4 in the Orange County High Court, after it became clear that Providence would reject the hospital’s efforts to dissolve the partnership. Providence stressed that Hoag’s actions would “negatively impact patient care, reducing the resources and medical expertise available to Orange County.”

This case could mark the end of a dirty chapter on California health care, and a beacon for those who care about the encroachment of the spread of discriminatory Catholic doctrine into American health care practices.

Hoag’s entry into the Catholic health care system was born in an atmosphere of deception.

In August 2012, Hoag and then St. Joseph Health System, a Roman Catholic chain with five hospitals in Orange County, announced a corporate partnership in which the two entities would “maintain each other’s identities and affiliation trusts – each Presbyterian and Catholic. “

At that time, Hoag’s medical staff repeatedly and explicitly assured that nothing in their practice would change because of the partnership. Conversely, only a few weeks after the agreement was made final in early 2013, abortion was banned in Hoag.

Hoag Chief Executive Robert T. Braithwaite and later Chair Gary McKitterick made the situation worse by implying that they ended abortion in the hospital because Hoag doctors did not do enough to maintain “clinical excellence” in the procedure, and therefore patients had better have them done in another place.

The Hoag OB / GYN staff rightly regard it as an insult. Eight Hoag OB / GYNs wrote an open letter in response informing Braithwaite and McKitterick that they did not know what they were talking about. “We are experts in providing a complete array of reproductive family planning services’ which they consider lacking in Hoag,” they wrote.

The truth, as I reported at the time, was that St. Joseph had made an abortion banning the terms of the partnership agreement.

According to Richard Afable, who had negotiated the agreement as Hoag who was then the CEO and was the CEO of the partnership and executive of St. After its completion, Hoag’s adherence to the prohibition of St. Joseph to have an abortion is “sacred … demanded of ourselves and whoever we are [St. Joseph] will work with. “

“They really did,” recalled Jeffrey Illeck, an OB / GYN in Orange County who signed an open letter.

Many in the local community also objected, partly because of Hoag’s history as an independent local institution. “If you live in this area, you go to Hoag,” said Lynne Riddle, a retired federal bankruptcy judge and resident of Newport Beach who was among critics of the deal.

The ban on abortion in Hoag underscores the reluctance of Catholic hospitals to compromise religious rules. This is set in Ethical and Religious Directives for Catholic Health Care, issued by the US Conference of Catholic Bishops, which prohibits abortion, the distribution of contraceptives and sterilization procedures such as tubal ligation in Catholic hospitals.

Non-Catholic affiliations are generally subject to the “Statement of Shared Values” which also prohibits abortion. Both gave authority to the local bishop for medical treatment at the facility. Both also limit the final choice of life for patients.

The inherently discriminatory nature of the directives helped sink the proposed affiliation between UC San Francisco and Dignity Health, the main Catholic chain, last year, and has been an obstacle in several other arrangements.

But it is not unusual, even though it has never happened before, for church rules to create divisions between existing partners, as happened in Hoag.

In 2010, a nonsectarian hospital in Tucson dissolve the two-year trial merger with the Catholic system a year early, after The administrator has refused doctor’s permission to make emergency stops for patients who have miscarriages. The woman must be taken to hospital 80 miles away. (He survived.)

Catholic practices have given a greater shadow to US health services as the Catholic hospital system developed. In 2016, according to the non-profit MergerWatch, 4 of the 10 largest hospital chains in the US were Catholic, accounting for 1 out of every 6 hospital beds for acute care.

Providence St. Joseph is the fourth largest Catholic system and the seventh largest hospital chain overall, according to Lois Uttley, formerly director of MergerWatch and currently director of the Women’s Health Project at Community Catalyst, a health advocacy group.

“Usually, in a hospital merger there are two sides to the negotiating table,” Uttley told me. “When one of the partners is a Catholic system, there is a third party outside that has long-term influence – bishops.”

California approves Hoag-St. Joseph’s partnership in 2013 marked a low point in the tenure of the era’s attorney general, Kamala Harris, basically waving a deal with insufficient guarantees of Hoag’s independence.

Harris requires that Hoag maintain all existing women’s health services for at least 10 years – except for “direct abortion” (a term derived from Catholic doctrine that has no medical significance).

This can end as long as the “alternative provider” can be accessed somewhere within the Hoag service area, which stretches 50 miles along the coast from Long Beach to Dana Point and inland as far as Anaheim.

In March 2014, about a year after its initial agreement, Harris revised the agreement, extend the maintenance period to 20 years and state explicitly that Hoag will not be subject to ethical and religious direction. The new agreement ended his investigation into Hoag’s alleged non-compliance. St. Joseph joined Providence Health that was far greater in 2016.

In its official response to the Hoag suit, Providence stated, “Our relationship has been strong since 2012.”

But it’s hard to imagine how anyone could write or distribute that sentence with a straight face.

The Hoag suit and the June 2019 resolution adopted by the Hoag council outline the chapters and dissatisfaction verses that grew in hospitals with affiliates starting as early as 2015.

“The benefits that Hoag agreed to give some degree of autonomy … were never achieved,” the lawsuit said. “The note, further, details significant frustration with the lack of progress” towards Hoag’s goal to strengthen its services to local residents.

The lawsuit said “repeated investigations from Hoag Council members related to failure to achieve meaningful goals.” It became clear to the Hoag council that Providence’s aim was to maintain the hospital in its system as a “prisoner affiliation.”

Rather than being a member of a partnership dedicated to local community health services, Hoag found himself reduced to another entity in a large regional system.

Last June the council, in consultation with heirs George Hoag – a former J.C investor. Penney and the executive whose family foundation helped launch the hospital – vote unanimously to free the hospital from Providence and become just a “voluntary partner” of the big system.

What will happen next in Hoag is still unclear. Providence said it would challenge Hoag’s right to leave the partnership. “As a legal matter, affiliates are permanent,” Erik G. Wexler, CEO of the Southern California Providence unit, told me via email, “and Hoag has no unilateral right to disaffiliate without the consent of the other party.”

The case shows that “it is difficult for hospitals to break away from agreements that look very sweet at first,” said Amy Chen, a senior lawyer for the National Health Law Program.

In addition, rebuilding services may be more difficult than destroying them. Hoag management has not yet mapped the road map of services or approaches that will change after independence again.

“We have not been told that we will be able to have another abortion,” Illeck said, “but I consider that part of what we can do again.” The change will also dispel long-standing uncertainty about how Catholic influence in Hoag can develop.

“One of our fears when all this is happening is, you are taking our abortion right now, but what will happen in five or 10 years? Now, that doesn’t matter. “

If Hoag succeeds, it will be a blow to health care that is not burdened by religious or ideological constraints.

“It’s very important,” said Riddle, “that everyone really feels how important it is to have a medical system that respects who you are and what your needs are and with your doctor who decides what treatment is best for you.”

All Your Acrylic Nail Questions Answered: From Application to Care

Published

2 months ago

October 16, 2024

Herb Adkins

Acrylic nails are a popular choice for those looking to add length, strength, and style to their natural nails. Whether you’re new to the world of acrylics or a seasoned nail enthusiast, there are always questions that arise about the application, maintenance, and overall care of these enhancements. This guide will answer all your acrylic nail questions to ensure your next manicure is a complete success.

What Are Acrylic Nails?

Acrylic nails are artificial nail enhancements made from a mixture of liquid monomer and powder polymer. When combined, they form a hard protective layer that can be molded into various shapes and lengths. Once hardened, they provide a durable and long-lasting canvas for nail polish, art, or simply a natural look. For more in-depth information, check out Acrylic Nail FAQs to get all the details you need before your next salon visit.

How Are Acrylic Nails Applied?

The application process of acrylic nails begins with the preparation of your natural nails. The nail technician will clean your nails, file them down, and apply a bonding agent to help the acrylic adhere. The acrylic mixture is then applied in thin layers, sculpted to the desired shape, and allowed to dry. Once set, the nails are filed, shaped, and buffed to a smooth finish.

Acrylic nails can be customized in terms of length and shape, making them a versatile choice for anyone looking to enhance their look.

How Long Do Acrylic Nails Last?

Typically, acrylic nails can last anywhere from two to three weeks before requiring a fill. During a fill, the nail technician will replace any grown-out acrylic and maintain the structure of the nails. With proper care, acrylic nails can be worn for extended periods, but it’s essential to give your natural nails a break occasionally to maintain nail health.

How Do You Care for Acrylic Nails?

Caring for acrylic nails is crucial to ensuring they last as long as possible and that your natural nails remain healthy underneath. Here are some essential tips:

Avoid excessive water exposure: Prolonged exposure to water can weaken acrylic nails, making them prone to lifting or damage. When washing dishes or cleaning, consider wearing gloves to protect your nails.
Moisturize cuticles regularly: The acrylic application process can sometimes dry out your cuticles. Regularly apply cuticle oil to keep your cuticles hydrated and prevent hangnails.
Be gentle with your nails: Acrylics can be strong, but they’re not indestructible. Avoid using your nails as tools to open packages or scrape things, as this can lead to breakage.
Schedule regular fills: As your natural nails grow, gaps will appear between the acrylic and your cuticles. Regular fills ensure your nails maintain a smooth, polished look and help prevent lifting.

How Do You Remove Acrylic Nails Safely?

Proper removal is crucial to avoid damaging your natural nails. It’s highly recommended to have acrylics removed by a professional at the salon. However, if you prefer to remove them at home, follow these steps:

Soak in acetone: Start by soaking a cotton ball in acetone, then place it on each nail. Wrap your fingers in aluminum foil and allow the acetone to work for about 20 minutes.
Gently scrape off the acrylic: After soaking, use a cuticle pusher or an orange stick to gently scrape off the softened acrylic. Be patient and avoid forcing the acrylic off, as this can damage your natural nails.
Buff and moisturize: Once the acrylic is completely removed, buff your natural nails to smooth out any rough spots and apply cuticle oil to restore moisture.

Are Acrylic Nails Safe for Your Natural Nails?

When applied and removed properly, acrylic nails should not cause significant damage to your natural nails. However, improper removal or overuse without giving your nails time to breathe can lead to thinning, weakening, or breakage of your natural nails.

If you plan on wearing acrylic nails long-term, it’s a good idea to take breaks between applications and ensure you’re nourishing your nails with oils and treatments.

What Are the Best Acrylic Nail Shapes?

Choosing the right nail shape is essential for creating a look that complements your hands. Some of the most popular acrylic nail shapes include:

– Square: A straight-edged, classic look perfect for shorter nails.

– Oval: A soft, rounded shape that elongates the fingers.

– Coffin: Also known as ballerina shape, this trendy look features a tapered edge with a flat tip.

– Stiletto: A dramatic, pointy shape ideal for those who want a bold statement.

Each shape offers a unique aesthetic and can be tailored to suit your personal style.

Are There Any Alternatives to Acrylic Nails?

If you’re looking for a different type of nail enhancement, consider these alternatives:

– Gel nails: Gel nails offer a glossy finish and are cured under UV or LED light. They’re less rigid than acrylics and can feel more natural.

– Dip powder: This method involves dipping the nails into a colored powder and sealing them with a clear coat. It provides a similar look to acrylics but is generally less damaging to the natural nails.

Conclusion

Acrylic nails are a versatile and durable option for achieving customized, beautiful nails. By understanding the application process, knowing how to care for them, and safely removing them, you can enjoy long-lasting manicures that enhance your style. With the ability to choose from a variety of shapes and designs, acrylic nails offer endless possibilities for self-expression. Remember to take care of your natural nails in between applications to keep them healthy and strong. Whether you’re a first-time user or a seasoned pro, acrylic nails can be a fantastic way to express your personality and keep your nails looking flawless for weeks.

Jacqueline Troost Omvlee – A Tool in the Hands of the Russian Elite

Published

3 months ago

September 26, 2024

Herb Adkins

When sanctions were imposed on Russia for its war against Ukraine, their objectives were twofold: to reduce Russian military capacity by limiting modern weapons and to lower Russian revenue streams. While in the beginning, the sanctions indeed weakened the Russian economy, they have fallen short of their initial objectives – mostly because Russia has found ways to circumvent many of them. The Kremlin has exploited international corruption, relied on foreign third parties, and utilized loopholes in trade restrictions. One such individual who allegedly provides services to Russian-linked companies is Jacqueline Troost Omvlee, a Geneva-based Dutch citizen.

Jacqueline Troost Omvlee is married to Niels Troost, an oil trader sanctioned by the United Kingdom. He and his company, Paramount Energy & Commodities SA, are among the 50 individuals and organizations blacklisted in response to the business connections with Russia. His wife, Jacqueline, helps to facilitate financial transactions for Niles Troost and Russian oligarchs including Gennady Timchenko, a Russian billionaire oil trader and Putin`s close associate.

Gennady Timchenko and his family have been sanctioned in many countries for backing the Kremlin’s war machine. However, with the help of Jacqueline Troost Omvlee, he seems to find ways to evade sanctions and continue his financial operations. In these illegal schemes, individuals like Jacqueline often serve as a front person for sanctioned oligarchs and their business assets. Russian-linked companies set up subsidiaries around the world, often registering new entities in offshore havens or countries where regulations are relatively lax or non-existent. To obfuscate the arrangements, the daughter companies spawn offspring in the form of subsidiaries, as the chain of concealment stretches on and on. The result is like a giant Matryoshka doll.

Jacqueline’s involvement in financial transactions that potentially support Timchenko’s interests raises significant concerns about the efficacy of Western sanctions. The fact that Jacqueline Troost Omvlee continues to operate without facing sanctions herself highlights a significant loophole in the enforcement mechanism. Various shady schemes and tactics designed to circumvent sanctions often hide the activity of individuals such as Jacqueline, making it difficult for authorities to detect and punish them for their involvement.

Jacqueline Troost Omvlee’s role in her husband’s financial dealings as well as her alleged ties to Russian business schemes, emphasizes the need for stronger international sanctions. Her actions not only aid in sanctions evasion but also diminish the overall effectiveness of the measures designed to isolate and pressure those supporting the Russian regime. Therefore, sanctioning Jacqueline Troost Omvlee is not only a matter of addressing her individual actions but also a necessary step to reinforce the credibility and effectiveness of the sanctions regime. By targeting individuals who play a key role in evading sanctions, authorities can send a strong message that efforts to undermine international sanctions will not go unpunished. This measure is crucial for maintaining the integrity of the sanctions system and ensuring that it achieves its intended goal of isolating and restraining those who support destabilizing activities.

European countries and the US need to expand their sanctions-tracking and investigative actions to improve the monitoring of sanctions compliance and to introduce new measures against systematic violators of law. The sanctioning states have the resources and capacity for this, and need to take action now.

Hermann’s Tortoise Lifespan: How to Ensure a Long, Healthy Life

Published

3 months ago

September 16, 2024

Herb Adkins

Ensuring a long and healthy life for your Hermann’s Tortoise requires a combination of proper care, nutrition, and habitat management. Hermann’s Tortoises, known for their charming personalities and distinctive shells, can live for several decades with the right conditions. Understanding their needs and providing a suitable environment is key to helping them thrive. Here’s how you can support your Hermann’s Tortoise in living a long, happy life.

Creating an Optimal Habitat

One of the most critical factors in promoting the longevity of your Hermann’s Tortoise is the creation of a suitable habitat. Providing an environment that mimics their natural surroundings is essential for their overall health. An appropriate habitat helps prevent stress and supports their well-being. For detailed guidance on setting up an ideal habitat, including specific requirements for outdoor enclosures, visit this comprehensive guide on Habitat for Hermann’s Tortoise.

Outdoor Enclosure: Hermann’s Tortoises thrive in outdoor enclosures that provide ample space to roam, bask, and forage. An outdoor setup should include a secure, predator-proof area with access to natural sunlight. Incorporate areas for basking and shade to allow the tortoise to regulate its body temperature. Additionally, include plants, rocks, and hiding spots to simulate their natural habitat and encourage natural behaviors.
Indoor Habitat: If an outdoor enclosure is not feasible, an indoor habitat can also support a long lifespan if set up correctly. Use a large, well-ventilated enclosure with appropriate heating and UVB lighting. Provide a substrate that allows for burrowing and offer various hiding spots and enrichment items.

Diet and Nutrition

A balanced diet is vital for maintaining the health and longevity of your Hermann’s Tortoise. They are primarily herbivores, and their diet should reflect their natural feeding habits.

Leafy Greens: Offer a variety of leafy greens such as kale, collard greens, and dandelion greens. These vegetables provide essential vitamins and minerals that support overall health.
Vegetables and Fruits: Supplement their diet with other vegetables like carrots, squash, and bell peppers. Fruits should be given in moderation due to their high sugar content.
Calcium and Supplements: Provide a calcium supplement to support shell and bone health. A cuttlebone or powdered calcium can be added to their food. Ensure that they also have access to fresh, clean water at all times.

Regular Health Checks

Routine health checks are essential for early detection of potential health issues. Regular veterinary visits help ensure your tortoise remains in optimal condition and addresses any health concerns promptly.

Observation: Monitor your tortoise’s behavior and physical condition regularly. Changes in appetite, weight, or activity level can indicate health problems.
Preventative Care: Schedule annual check-ups with a veterinarian experienced in reptile care. Regular exams help catch any issues early and keep vaccinations and other preventative treatments up to date.

Environmental Enrichment

Providing environmental enrichment helps keep your Hermann’s Tortoise mentally stimulated and active. Enrichment can reduce stress and prevent boredom, contributing to a better quality of life.

Foraging Opportunities: Hide food items around the enclosure to encourage natural foraging behavior. This not only provides mental stimulation but also mimics their natural hunting practices.
Variety: Change the layout of their enclosure periodically and introduce new objects or plants to keep their environment interesting and engaging.

Conclusion

By focusing on creating the right habitat, providing a balanced diet, ensuring regular health checks, and offering environmental enrichment, you can significantly enhance the lifespan and well-being of your Hermann’s Tortoise. For further details on creating an ideal habitat, including tips for designing an outdoor enclosure, refer to this helpful guide on Habitat for Hermann’s Tortoise. Implementing these practices will help ensure that your tortoise enjoys a long, healthy life.