There is no better place to consider the hard choices now confronting the Archdiocese of Boston than in Dorchester, the city's largest neighborhood and, safe to say, among its neediest.
Consider: A storm is brewing over the church's proposal to consolidate Dorchester's eight parochial schools into four, part of an ambitious attempt to save a system that has seen enrollment dwindle from 150,000 in the '60s to less than 50,000 today. At the same time Cardinal Sean O'Malley has created another storm by suggesting that things can't go on as they have at the archdiocese's Caritas Carney Hospital, raising questions about this beloved but money-losing Dorchester institution.
Saving souls? Mending bodies? Educating kids? God's work all, but a lot to ask of mere mortals. We all have to make choices, the archdiocese very much included. Boston City Council president Maureen Feeney, a good Catholic girl and mom, puts it well: "They need to step back and get a grip. They need to decide what their mission is."
Much has been written about Carney and its fate in the last few weeks. But to me the two scariest words from the archdiocese on its struggling hospital chain are these: "go forward" - as in the church's Caritas Christi Health Care System is again pursuing an independent "go forward" strategy for the future. "Get out," in fact, should be the strategy of choice for the community and for the church itself, and the sooner the better.
We "are convinced that we have the experience and the resources to achieve our goals," O'Malley said in a memo this month. If the archdiocese has proven anything over the years it is that it has neither the experience nor the resources to run the second-largest hospital system in Massachusetts' highly competitive market. What happens next matters, and matters a lot for a community that needs a strong Catholic Church more than ever.
O'Malley had it exactly right when he tried to attract a Catholic hospital system operator to take over his six chronically underfunded hospitals. First, Ascension Health, the nation's largest Catholic healthcare system, tried to negotiate a deal with the archdiocese and failed. Catholic Health Initiatives, a Denver chain, also walked way. The reason both deals failed was never clear. Dr. John Chessare, Caritas's interim chief executive, says he believes neither buyer felt it could make the margins needed to justify the investment. Others think the archdiocese loaded too many preconditions onto what was a marginal deal anyway.
Finding a model that works for Carney - whether as an acute-care hospital or something less - is important. Getting the archdiocese out of the hospital business is more important. Carney, which lost $2.1 million last year, is not the essential problem in a chain with $1.2 billion in revenue.
Attorney General Martha Coakley has a critical role to play. When Beth Israel Deaconess, another faith-based hospital, was in trouble a few years ago, then-attorney general Tom Reilly threatened to force a sale unless its parent, CareGroup, got its house in order. Coakley, too, needs to think broadly about her options and not presume Caritas needs to stay intact. Says Dr. Chessare: "My belief is the archdiocese is open to talking to any Catholic healthcare company that would want to come and talk."
We need the Caritas hospitals, which served 1.1 million patients last year, even if we don't need Caritas itself. To succeed, the hospitals need the kind of deep pockets and strong management that a big operator can bring. Another plus: Imagine raising money for a Catholic system not handicapped by a brand badly damaged by scandal and parish closings.
The archdiocese needs to find a way to exit the hospital business. In a world where the have-nots are falling further behind by almost every measure, there is more need than ever. The archdiocese can't do everything, not in Dorchester or anywhere else. It needs to choose, and sooner rather than later.
Steve Bailey is a Globe columnist. He can be reached at bailey@globe.com or at 617-929-2902.
