By Faye Sonier
Over the last few weeks, public comment on the issue makes it apparent that there is still confusion surrounding the funding of abortion procedures in Canada.
Joyce Arthur wrote a piece at Rabble.com where she lambasted Campaign Life Coalition’s Defund Abortion campaign; painting the protestors as naïve, uninformed activists fighting for a hopeless cause. Two weeks ago, a letter written by Health Minister Deb Matthews was made public and also garnered attention.
In November 2012, The Evangelical Fellowship of Canada (EFC) released the report Provincial Decisions: Abortion Funding in Canada. The document examined the provincial and territorial governments’ roles in determining abortion funding for their jurisdictions. It took months to prepare this short report. Untangling the issue of abortion funding in Canada is complex, notably because most people – including those within government – are working from false assumptions or erroneous information advanced by a select group of pro-choice activists. We reviewed original government documents, read case law and called government officials to confirm our conclusions. This project was, quite surprisingly, no small endeavour.
The report, which was updated last month, is available for free download. But let me tackle the three most common myths associated with abortion funding in Canada for you right here. Check out the report for more information and source materials.
1. Myth: The Canada Health Act requires that abortions be funded by the government
The Canada Health Act does not state that abortions must be funded by provincial or territorial governments. It does state that “medically necessary” services are to be covered.
This Act sets out which criteria provincial and territorial governments must meet in order to receive transfer payments from the federal government. While healthcare is a provincial and territorial matter, the federal government began participating in the funding of healthcare procedures as it desired that citizens across the country have equal access to healthcare services.
The federal government currently pays for approximately 40% of all healthcare services in Canada via transfer payments to the provinces. The provinces pay for the balance.
If the federal government determines that a provincial or territorial government isn’t meeting certain Act criteria, such as failing to provide “medically necessary” services, it can choose to withhold funds from its transfer payments.
2. Myth: Abortions need to be considered “medically necessary” services
Contrary to the arguments that some pro-choice advocates advance, determining which medical procedures may or may not be considered “medically necessary” in Canada is no easy task. Actually, it’s a bit of nightmare for everyone, from seasoned judges to patients simply seeking medical care.
Provincial governments, not the federal government, determine which services are considered “medically necessary” and which are not. They do so in consultation with their respective colleges of physicians and/or other medical groups. If a province determines a service is “medically necessary” it will fund it.
When citizens have challenged their government’s non-funding of procedures, the courts have appeared to struggle with what the term “medically necessary” legally requires of the provinces. The courts have alternatively provided extremely broad and vague definitions of what can be considered necessary (“a medical service that is essential to the health and medical treatment of an individual”) or they have simply determined whether the specific procedure being considered is necessary. No court has yet provided citizens or government with clear criteria by which to assess whether a procedure should be considered “medically necessary.”
It is also not a matter of consensus within the medical community that any or all abortions are medically necessary. For example, New Brunswick has a regulation which sets out that an abortion will only be funded in that province if two physicians affirm in writing that the procedure is “medically necessary” in the particular circumstances.
Additionally, an association of physicians, Canadian Physicians for Life, recently released a thorough and compelling public statement explaining why they believe “that no abortions are medically necessary.” In 2012, an international association of over 140 medical professionals released a statement setting out that abortion is never medically necessary. The statement is known as the Dublin Declaration. The Declaration has now garnered over 700 signatures.
3. Myth: Provinces and territories cannot choose to defund abortion procedures
By virtue of The Constitution Act, 1867, provinces determine and manage healthcare in their jurisdictions. If, however, a province chooses to defund abortions and the federal Minister of Health interprets such decision as a violation of a provision of the Canada Health Act, the federal government could choose to withhold some funding from the healthcare transfer payments.
However, over the last decade various Ministers of Health have responded differently to abortion funding challenges. Whereas one Minister (Ujjal Dosanjh) took action when faced with a province declining to fund abortions at a Morgentaler clinic, another Minister (Tony Clement) chose not to pursue the matter, and did not withhold funding from the province for its decision.
Historically, it appears that the deductions made to transfer payments to provinces that refuse to cover all or some abortion related costs are minimal. For example, in 2001, the Nova Scotia Department of Health refused to cover the facility fees for a private abortion clinic. The federal government of the day stated that this was a violation of certain provisions of the Canada Health Act and said it would deduct $39,000 from the federal transfer payment, a minimal sum. The provincial government responded that it would forego the $39,000 rather than adopt the federal government’s interpretation of the term “medically necessary services.”
The facts on abortion funding mean that there is room for pro-life advocacy and engagement.
Provincial Ministers of Health could and should be persuaded to reconsider their provinces healthcare priorities. Attention may be drawn to the associations of physicians who are making clear, compelling and public statements about proper and comprehensive healthcare for women, and how this healthcare need not include the aborting of children.
This is not a hopeless cause. Public opinion is split on the issue, with less than half of Canadians supporting the general trend of government funding for abortions on demand. A 2010 Angus Reid Public Opinion poll found that only 44% of respondents believed that our “health care system should fund abortions whenever they are requested.” 39% believed the procedures should only be funded in cases of emergencies and 10% believed that abortions should never be funded.
While it may have been a complex task to untangle the legislation and policies relating to abortion funding, our advocacy work going forward need not be. The message is simple: our tax dollars don’t need to fund abortions.