Two topics that are closely related to the daily work and the primordial concern of Catholic healthcare givers are the meaning and sense of Catholic healthcare institutions, and the relationship between a particular Church and the universal Church, especially since the Second Vatican Council. Some question whether it is worthwhile to maintain independent Catholic institutions, rather than working with others in nondenominational healthcare institutions. Christian institutions are indispensable as a defense against the well-organized forces of evil in the world, and because togetherness is needed in the struggle for good and for faith. Without this togetherness, the danger exists that the power of faith will be taken over by the power of money and financial interest groups. The elements of the Catholic identity of institutions and organizations are a service to the world, the Gospel message, a balance between technology and humanism, a permanent solicitude for the whole person, and a respect for human liberty. This Catholic identity must be fostered in our institutions, especially among the laypeople working there. The relationship between the universal Church and local Churches has come under stress since the Second Vatican Council, and a balance must be found. The problem has two aspects: the theological, and the cultural and psychological. A sound communion theology must be established to provide a good perspective on the relationship. In addition, a dialogue must be established between Rome and the particular Churches to prevent the universal message of Christ in his Gospel from conflicting more and more with local styling of the message.(ABSTRACT TRUNCATED AT 250 WORDS)