Yesterday's Louisville (KY) Courier Journal reports that church-state questions are being raised regarding the agreement for the proposed merger of Louisville's University Hospital with two other Kentucky health care systems to create a state-wide network that would be controlled by Catholic Health Initiatives. All of the participating hospitals, including University Hospital and Louisville's Jewish Hospital, have agreed to follow Catholic health care policies. This means, for example, that none of the hospitals would perform tubal ligations or dispense birth control devices or medications. At issue is whether University Hospital should be considered a public institution subject to constitutional constraints on endorsing religion. It is the main teaching hospital for the University of Louisville, a state institution, and the University owns the hospital real estate. The hospital is also the city's main provider of indigent care. The University, however, says this does not make the hospital a public institution. The merger must still be approved by the governor of Kentucky, as well as by the Catholic bishops of Lousville and Lexington.