Bioethics Blogs

Provincial Funding Of IVF Should Be Restricted On The Basis of Income

Vida Panitch argues that the Quebec government should pay for IVF for those with biological or social infertility, but only for those who can’t afford it.

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When provincial funding of IVF was introduced in Quebec in 2010, the government cited cost-effectiveness as the reason. Public funding promised to cut down the cost of treating complications associated with multiple births (which are likely to occur when patients have multiple embryos transferred at once to avoid the expense of future cycles). Now, in 2014, as legislators in Quebec announce plans to repeal provincial funding of IVF, the government again cites cost-effectiveness. This is because the program has far exceeded its expected budget – coming in closer to $70 million a year than the projected $36 million a year.

The possible cancellation of the IVF program – and its replacement with tax credits for infertile couples only – raises an important question about who should foot the bill for childbearing: society or the individual. Quebec’s Minister of Health called the existing IVF program an “open bar” on a “non-essential service.” Here, he echoes the former President of the Ontario Medical Association who recommended, back in the 1990’s, that his province de-insure IVF claiming that the system had allowed “frills to creep in.”

allegory-of-fertility.jpg!Blog

Allegory of Fertility by Jacob Jordaens (1593- 1678)

But when it comes to health services, what is a frill and what isn’t? The traditional test in Canada is that of ‘medical necessity.’ This concept is notoriously difficult to define in the case of infertility, however, because infertility has both a biological and a social component.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.