This week, Canadian Affairs published an article on access to in vitro fertilization, an expensive and time-consuming treatment that helps individuals and couples struggling to conceive.Â
Notably, access to IVF varies considerably across the country.
In Alberta, British Columbia, Saskatchewan and the territories, there is no public funding for IVF, meaning approximately 25 per cent of Canadians live in jurisdictions where they must pay out of pocket for treatment.Â
The funding available in the other provinces varies in form and amount. Residents of the Atlantic provinces and Manitoba are eligible for grants or tax credits that range from $5,000 to $10,000 in value. Ontario and Quebec residents are eligible for coverage of a single IVF treatment cycle, which costs between $10,000 and $20,000.
Healthcare funding is always a question of trade-offs. The government cannot — and should not — fund every conceivable want or need. Certain types of medical procedures are best paid for privately, if at all (leg lengthening surgery comes to mind).Â
Fertility treatment, we would argue, does not fall within this camp. There are compelling reasons for the government to ensure IVF treatment is accessible to Canadians wherever they live.
Primarily, infertility is a medical issue.
Like many medical conditions, infertility is a combination of genetics, lifestyle and environmental factors that affect both men and women’s health. Specifically, underlying medical conditions such as endometriosis, deferred childbearing, diet and environmental exposures to plastics are all known to affect fertility.
We have long accepted that people should not pay out of pocket for medical treatments caused by their own behaviour (such as smoking) or factors outside their control (such as pollution). Why should they pay out of pocket for a medical condition like infertility?
Some may argue against IVF funding due to its uncertain success rate. Just one-third of IVF cycles are successful for women under age 35. But Canada does not deny patients costly medical treatments (such as chemotherapy) even though their success rate may be low.
There are also equity reasons for funding IVF access.
One of the reasons IVF treatment is in high demand is many women put off having children until later in their childbearing years. Often, this is because women have chosen to prioritize higher education and their careers.
These changes are for the good — and are necessary if Canadian women are going to achieve parity with men in earning power and professional fields. But here too there are tradeoffs. If Canada prioritizes gender equity as a worthy social goal, it should be willing to bear some of the costs that are a consequence of it.
We also note that vasectomies, a male sterilization procedure, are generally covered under provincial health insurance plans. If we’re going to cover a procedure to make men infertile, how do we justify not covering a procedure that promotes fertility?Â
Finally, Canada needs more people. Specifically, it needs young people who will become tax-paying workers who help fund Canada’s vast social state.
At present, policy is oriented toward achieving this population growth through immigration.Â
Making IVF treatment accessible supports domestic population growth. Indeed, a 2019 study found that demand for IVF jumped five-fold in Quebec between 2010 and 2015 after treatment became publicly funded.
We recognize there is no such thing as a free lunch. Funding IVF from the public coffers means raising taxes or finding savings elsewhere. It also means drawing lines around who is eligible for coverage and how many times treatment will be covered.
But not funding IVF treatment does not seem like a defensible decision in a society like Canada’s.
