In the view of the Catholic hospital community, it is the American tradition that health care is an "essential community service." It is essential because persons requiring health care have no options other than to seek health care. It is community because in this age of mega-everything, the provision of health care will ultimately and always be determined by encounters and relationships within the most local community. It is service because . . . those of us in health care really do not sell a product: we serve.

Because we in Catholic health care are a church ministry, the words "essential community service" mean profoundly more. It is essential that we serve God and His people, and our presence calls all to our communities of healing.

If our view is correct, an interesting question emerges: Is health care a business which makes a profit by providing a service, or is health care a service which makes a profit to remain in business?

. . . The real issue is motivation, or corporate conscience, or driving force, or organizational soul, or whatever the right words are to describe what really makes an organization tick. Believing that one cannot serve two masters, I pose the question: Is the primary motivation of health care to care for people within a community, or to provide financial gain to investors?

. . . If health care is viewed primarily as an "essential community service," particularly from our perspective as Catholic, there is only one set of answers. And our nation may have some very difficult decisions to make.