SEATTLE – Hay muchas razones por las que los proveedores chicos de atención a la salud quieren afiliarse a los grandes sistemas hospitalarios – por ejemplo más dinero, pacientes y tecnología. Pero el asunto tiene más aristas.

Actualmente casi la mitad de las camas de hospital en Washington forman parte de sistemas de atención médica basados en la fe, proporción que hace dos años de la mitad. Algunas opiniones señalan que tal tendencia podría llegar a limitar el tipo de cuidados disponibles para los pacientes –en especial de procedimientos no alineados con la doctrina Cristiana – y están discutiendo el tema.

Las fusiones entre prestadores de servicios de salud incluyen la de PeaceHealth, de Vancouver, con la Universidad de Washington (UW, por sus siglas en inglés), y la de los Centros de Enseñanza de Salud de Spokane (STHC) con Providence Health Care.

Leah Rutman, consejera de políticas de ACLU en Washington, comenta que vigilarán de cerca qué tanto son afectados los socios seculares de estas fusiones que se dan bajo las Catholic Ethic and Religious Directives (Normas Católicas Éticas y Religiosas), código que regula los cuidados de la salud.

“Estas directrices establecen que a esos sistemas Católicos de atención médica no se les permite brindar muchos tratamientos de fertilidad, servicios de salud reproductiva, ni servicios al final de la vida. Se trata de preocupaciones muy reales, porque la interpretación que haga cada hospital o sistema de salud de estas normas, puede ser diferente.”

Las organizaciones participantes en las fusiones han declarado que la atención al paciente no correrá riesgo alguno. Rutman señala que una parte del dinero público se usa para la atención al paciente en los hospitales y clínicas afiliados, y agrega que la Constitución del estado de Washington estipula que “el dinero público no será destinado… para sostener a institución religiosa alguna.”

Según el grupo “Compassion & Choices” (Compasión y Opciones de Elección), la atención al final de la vida y la ley “Death & Dignity” (Muerte y Dignidad) están en riesgo en el estado de Washington. Robb Miller, director ejecutivo de la organización, afirma que la ley permite que las organizaciones religiosas se abstengan.

Su temor es que los profesionales médicos y trabajadores sociales no recomienden a otros profesionales fuera de su corriente de fe, ni den a la gente información que no va con sus normas religiosas.

“El consentimiento informado es uno de los más importantes principios en la práctica de la medicina. La retención de información y de recomendaciones es lo que realmente representa un problema en estos proveedores.”

Los estudiantes de medicina y de posgrado en ambas universidades también han expresado preocupación por las restricciones que pudieran surgir en la capacitación o la residencia, por causa de las directrices religiosas. Miller afirma que la mejor manera en que la gente puede informarse sobre las limitaciones en la atención es preguntar a su médico o su hospital.


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North Dakota's June 11 primary is inching closer and those running for legislative seats are trying to win over voters, including Native American candidates who are part of a movement energized by newly drawn political boundaries.

The organization North Dakota Native Vote said there are seven candidates with Indigenous roots seeking spots in the Legislature. Most are running in District 9, which was recently updated to reflect representation needs for two Native American tribes.

Natasha Gourd, a board member of North Dakota Native Vote, described them as a good mixture of candidates coming from both reservations in the area, with some running as Democrats and others as Republicans.

"We've seen an upturn in participation and just getting leadership development through Native candidates," Gourd observed.

The election wave comes after the state saw 10 Native candidates in legislative races two years ago. For her group, Gourd acknowledged the boost can be tricky because they cannot endorse everyone running. But she noted having greater assurances the areas will be represented by people from their community -- no matter if they have a different stance on certain issues -- is still a positive.

Gourd added trying to build on the momentum is also important for off-reservation districts.

"What they do at the state level, regardless of Native American people in North Dakota (being part of) federally recognized tribes, it does affect us," Gourd pointed out. "Most Natives in North Dakota do live off the reservation, so it does affect our populations."

Gourd stressed they need more Native voices at the state level speaking out about priorities within education, the housing crisis, energy issues and health care. She hopes the positive trends they're seeing inspire more civic participation among other racial and ethnic groups trying to get a seat at the policy table in North Dakota.

A new poll finds a near 20-year low in the number of voters who say they have a high interest in the 2024 election, with a majority saying they hold negative views of both President Joe Biden and former President Donald Trump. A group of Arizona elections officials and experts recently gathered to discuss the growing discontent with the state's current electoral landscape.

Stephen Richer, Maricopa County Recorder, said that if politicians are what he calls "single-minded seekers of re-election," he contends the state should change the political incentive structure.

"And if those incentives will change, then maybe we will be talking about more things in the Arizona Voter's Agenda and less things that are currently right now incentivized by what I still believe to be a minority, but a very passionate, very loud, and a minority that is definitely committed to acting on those issues," he said.

Richer added it is important to remember that despite Independent and unaffiliated voters being able to participate in the July 30th statewide primary, they were excluded from the state's March Presidential Preference Election, and that has caught the eye of some in the state. The bipartisan group Make Elections Fair Arizona is pushing for open primaries, but proponents of closed primaries believe they're crucial to maintaining the integrity of party ideals.

Amanda Burke, executive vice president with the non-partisan, nonprofit organization Center for the Future of Arizona, said more than half of unaffiliated voters do not feel they have leaders or candidates running who speak to the issues and causes they care about. She contends that then translates to who decides to show up at the ballot box and vote, and encourages Arizonans to imagine a different primary system if they want different outcomes.

"Otherwise we are going to continue to have some more outcomes in terms of people who are incentivized to speak to a small percentage of their base on either side who are really not representative of the larger views," she explained.

The Grand Canyon State allows voter-initiated amendments to the state constitution, but the Arizona Require Partisan Primary Elections Amendment would add the state's current primary practice to the state constitution, prohibiting future changes without another constitutional amendment. Make Elections Fair Arizona is still collecting signatures to get its measure on the November ballot.


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Wisconsin women have made progress in closing gaps when it comes to being elected to public office.

But some voices worry the movement might slow down as candidates see increasing levels of threats and harassment.

The Brennan Center for Justice recently issued findings that detail the threatening behavior those in the political arena are experiencing now.

Women were three to four times as likely as men to experience abuse targeting their gender.

Erin Vilardi, CEO and founder of the advocacy and assistance group Vote Run Lead, said this creates more unfairness in areas such as resource planning for a campaign.

"We see women candidates and incumbents right now having to pay for security," said Vilardi, "having to put in their budgets, in their campaign funds, in their line-items for their campaigns a security detail."

And Vilardi said because of the worsening climate, the threats are extending to almost all other candidates, including conservative white men.

She and other researchers called on party leaders to strongly condemn political violence. They also recommend that each state implement stronger protection for officeholders.

Vilardi said it's not just women candidates and incumbents having to deal with this behavior. Women working as top aides and political journalists are subject to more hateful rhetoric these days.

"This is something that permeates women in politics," said Vilardi, "not just for the folks that are stepping up to lead but for the ecosystem of women around them."

And if more women decide not to run or seek re-election as a result, Vilardi said this means there will be fewer opportunities for gender equality in leadership positions in state legislatures and Congress.

She urged constituents to send messages of support to women officeholders as they weigh these challenges and their political futures.

Support for this reporting was provided by the Carnegie Corporation of New York.



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