An innovative health plan offered by the Diocese of Lincoln, Neb., which excludes coverage for abortion and sterilization and includes such pro-life initiatives as natural family planning, is stirring hopes for a similar project nationwide.

The health plan, which has been in place for six months, may be “the foundation for a national Christian health care delivery system that puts morality and ethics before economics,” according to Michael O'Dea, the health-care consultant who helped put the project together.

Msgr. Robert Vasa, the vicar general of the diocese, said he was looking for health coverage that would not be antithetical to the religious beliefs of the priests, religious, and lay workers.

“Most plans would allow you to exclude abortions or sterilizations, but you still pay for it,” he said. “There was no effective way to tell them you're dissatisfied. So we decided to write our own plan.”

The diocese approached O'Dea, president and chief operating office of ValuSure Corp., a Michigan-based firm. A devout Catholic, O'Dea also founded Mother and Unborn Day Care, a crisis pregnancy center in Detroit and Southfield, Michigan.

“Our primary mission is to put together pro-life health care plans,” he said. “Of course, we have come to realize the key to making this happen is the Catholic Church.

“The Church has very clear thinking on what should be in a Catholic health care plan. They also have the critical mass to develop such plans.”

Most of this Church teaching is contained in the Catechism of the Catholic Church and the Ethical and Religious Directives for Catholic Health Care Services issued by the National Conference of Catholic Bishops in 1994.

In designing a plan, the diocese also sought out other experts. Dr. Paul Byrne, a neonatalist in Toledo, Ohio, and past president of the Catholic Medical Association, was consulted on issues concerning organ transplants.

His guidance here was consistent with the Catechism, which states: “It is morally inadmissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.”

The health plan, for instance, covers the donation of one kidney from a living person with two functioning kidneys, and the tissue transplantation of a cornea or heart valve from a dead person.

“The beginning- and end-of-life issues have been extremely important in developing health care plans,” O'Dea noted.

The Lincoln plan clearly spells out what is acceptable and what is not. It excludes abortion, sterilizations, and contraceptives, as well as in vitro fertilization and artificial insemination—for several reasons, including the fact that they separate the generation of new human life from the act of sexual union between husband and wife..

Included in the plan is coverage for reversal of sterilization and up to $400 per couple for natural family planning. O'Dea believes that adding natural family planning coverage sends a message: “When you put money into anything, you legitimize it. This is an endorsement of NFP.”

The Ethical and Religious Directives notes that Catholic health facilities “should provide, for married couples and the medical staff who counsel them, instruction about the Church's teaching on responsible parenthood and in methods of natural family planning.”

Instrumental in the creation of the plan were Midwest Select, a health provider network, and St. Elizabeth Community Health Center, a 208-bed hospital in Lincoln. These two organizations were able to provide the personnel and the facility to match the policy developed by Msgr. Vasa, O'Dea, and others.

The Omaha, Neb.-based Midwest Select began enrolling physicians in its preferred provider plan in February 1997. It has a predominantly Catholic orientation, being partly owned by Catholic Health Initiatives (CHI), currently the nation's largest Catholic health system.

Midwest Select attracts physicians and other health care providers to the system and credentials them according to national competency standards. According to its director of marketing, Ann Wozny: “We follow the language of the religious directives in our provider contracts.”

St. Elizabeth also is owned by CHI. As the major Catholic health facility in the diocese, it is important in granting hospital-admitting privileges to physicians. All Midwest Select physicians have privileges at St. Elizabeth.

The hospital is able to determine what is done on its premises, and its director of managed care, Kevin Flores, said, “We will not provide any services which violate any Catholic teaching.”

Being part of the CHI system, St. Elizabeth follows the same guidelines that apply to its other 69 hospitals and 48 long-term care and residential facilities. Joyce Ross, CHI's communications director, explained that the system is committed to the bishops' Ethical and Religious Directives.

According to its mission statement, CHI seeks “to nurture the healing ministry of the Church by bringing it new life, energy, and viability in the 21st century. Fidelity to the Gospel urges us to emphasize human dignity and social justice as we move toward the creation of health communities.”

This confluence of Catholic institutions, no doubt, was important in developing the plan in Lincoln. Currently, about 160 priests and religious sisters and 20 lay people are enrolled; the diocese expects another 50 or 60 now covered by an older plan will soon join.

Msgr. Vasa said the response of participants has been very positive. He noted that the cost savings are important, and the opportunity to direct the health plan with a clear conscience is highly desirable. Still, he is surprised at how much attention the plan has drawn around the country. “For me,” he said, “it seems to be a no-brainer.”

O'Dea hopes that other people of faith will agree. We're “excited about implementing similar programs with Catholic dioceses and religious orders, evangelical employers, associations, and pro-life/pro-family employers throughout the United States,” he said.

In fact, a similar plan has existed in the neighboring Archdiocese of Omaha for the past decade; it will begin to use Midwest Select as its preferred provider network on Jan. 1. Developed through Insurance Consultants Inc., it includes Bergan Mercy Care Center, another Catholic hospital.

For those who envision more such programs and, indeed, someday a national Catholic-based health system, the allure is clear. O'Dea argues this is an opportunity to promote the family and provide procedures that truly constitute health care.

According to Dr. Byrne, the past head of the Catholic Medical Association, a program designed along the lines of Lincoln's is one “which does what a health plan should do: aid and heal, never kill and harm. If you have an insurance plan, it should be based on moral principles.”

Joseph Esposito writes from Washington, D.C.