Defunding abortion: A non-starter

Cross-posted from Rabble - originally published November 1, 2013

 

The anti-choice movement has launched a national campaign to try to convince provinces to defund abortion. This campaign is the latest of numerous attempts over the years to defund abortion in several provinces (including B.C., Alberta, Saskatchewan, and Ontario), beginning immediately after the Supreme Court struck down Canada's abortion law in 1988.

Every single effort to defund abortion has failed and so will the current one. The anti-choice movement appears oblivious to history and evidence indicating that provinces will not and cannot defund abortion. Provincial governments know that it would violate women's Charter rights and the Canada Health Act, as well as clash with previous legal precedents. Defunding abortion would also invite an expensive (taxpayer-funded) court challenge that provinces would not likely win.

The current anti-choice campaign is mainly appealing to the public and their wallets, but this is also a lost cause. The public has little say in what medical services are covered by provincial health plans, because health-care coverage cannot be decided by majority vote for obvious reasons (to prevent inequity and discrimination). Taxpayer funding of health care works similarly to how citizens pay taxes. Citizens cannot choose which government services they are willing to pay taxes for, based on whether or not they use them or like them. Public funding for things like infrastructure, education, and health care benefit all Canadians. It's how we improve the lives of everyone and establish a degree of equity.

Nevertheless, since anti-choicers can't win on criminalizing abortion, they're trying to capitalize on the public's alleged dislike for funding it. A 2013 Angus Reid poll found that 43 per cent of Canadians support funding of abortions whenever they are requested, 42 per cent believe it should only be funded for medical emergencies, and 7 per cent think it should not be funded at all. Remarkably, this breakdown closely mirrored the percentages of Canadians who support the legal right to abortion in all cases (47 per cent) versus those who want at least some restrictions (41 per cent), and those who want it completely banned (7 per cent).

This implies that public support for defunding abortion may be just as meaningless as public support for restrictions -- for which there are no realistic prospects at all in Canada. Despite abortion being frequently in the news, most Canadians are probably not familiar with legal jurisprudence on the abortion issue and why women's legal right to abortion has been deemed integral to the exercise of their Charter rights. Further, most people don't know much about abortion practice in Canada, so mistaken beliefs are commonly reflected in polls. A 2010 poll found that 41 per cent of Canadians think abortions are only available during the first three months of gestation, when in fact it's available on request until 20 weeks, and after that only under compelling circumstances at a doctor's discretion (this is policy, not law). Many Canadians may also be unaware that abortion restrictions do not reduce the abortion rate. Their main effect is to increase hardship for women and put their health and lives at risk.

The main anti-choice arguments opposing the funding of abortion are numbered below, and come from the website of Campaign Life Coalition (primarily from here and here. I've shortened or combined a few of them for brevity.) My rebuttals are explained in more depth here, including citations. 

1. "Canadian taxpayers fund at least $80 million every year for the killing of children in the womb. That figure does not include the cost of common abortion complications, which could easily escalate the total cost to hundreds of millions of dollars annually!"

The overall cost of abortion care to the taxpayer is a pittance relative to health-care costs as a whole. Paying for abortion care is very cost-effective compared to unwanted birth. The social costs of raising unwanted children are prohibitive, since they are at higher risk for life dysfunction, including abuse and poverty. Complications from safe and legal abortion are extremely low, especially in Canada -- in the range of 1-2 per cent and mostly minor. If abortion was defunded in Canada, complications would increase because many low-income women would end up having a delayed abortion (medical risk increases with gestational age), or resort to unsafe clandestine abortion.

2. "There is a severe shortage of family doctors, nurses, and funding for elder care and for treatment of autistic children across Canada. Real medical needs are being ignored, patient wait times are outrageously long, and funding for cancer research has been cut."

This is a red herring argument. Other problems in the health-care system have nothing do with whether certain procedures like abortion should be funded. The cited issues will not be solved by defunding abortion.

3. "Abortion is an elective procedure that is not medically necessary. Our tax dollars should not subsidize life-style choices."

All abortions have already been deemed medically necessary by every province and territory, which means the procedure must be funded under the Canada Health Act, both in hospitals and private clinics.
The term "medically necessary" has been broadly defined to mean a "medical service that is essential to the health and medical treatment of an individual." This must include all abortions because every pregnancy poses some medical risks, even when the woman and her fetus are healthy. Further, the World Health Organization's definition of health also covers mental health. Women who can't obtain an abortion are at high risk of suffering negative psycho-social consequences. Lack of funding increases the chance that women won't be able to get a legal abortion and as a result, suffer ill health due to unwanted pregnancy or unsafe abortion.

Anti-choicers say that provincial governments have the exclusive right to decide whether to defund a particular service, and while that is technically true, it doesn't really apply to abortion. Provinces cannot simply defund all abortions, since even some anti-choicers will concede that a few are medically necessary to save the woman's life or in cases of rape and incest. Provinces must rely on the medical profession to help them define which abortions are necessary and which are supposedly not, but medical groups have refused to go along with this because they say all abortions are medically necessary (such as in Alberta in 1995). In any case, it's not up to doctors to decide on the medical necessity of abortion -- women have a right to abortion on request without having to state a reason.

Even if a naïve anti-choice provincial Health Minister tried to defund all abortions without the input of medical groups, it's extremely unlikely he or she would be successful. The media and the women's movement would have a heyday attacking such a dangerous and discriminatory policy, and the Health Minister probably wouldn't last long in his or her position. More importantly, defunding abortion would be unlikely to withstand constitutional scrutiny. When Saskatchewan citizens voted to defund abortion in a 1991 referendum, the government shelved it after its lawyers advised that defunding abortion would probably not survive a Charter challenge, as it would discriminate on the basis of sex. That's because only women get pregnant and only women need abortions. In addition, several court decisions have required provinces to fund abortions at clinics as well as hospitals, and legal expert Joanna Erdman has argued that abortion funding is protected under the Charter's gender equality guarantee.

Describing abortion as a "lifestyle choice" is derogatory to women. However, it could be said that a woman's decision to have a baby is not medically required -- she gets pregnant and has a baby because she wants to. But it's not a woman's reason for her decision that's at issue, it's the outcome. Childbirth and abortion must both be fully funded because women's reproductive capacity is integral to society, and the government cannot make childbearing decisions for women because they are rights-bearers.

Reproductive health care is health care. When anti-choicers say abortion should be defunded based on the idiotic claim that "pregnancy is not a disease," they should be consistent and also oppose funding for pre-natal care and childbirth.

4. "Over 96 per cent of abortions are performed for convenience as a back-up birth control method."

In contrast to this sexist and insulting falsehood, a woman's decision to have an abortion is a very serious one that is not taken lightly. Women are responsible moral agents who can be trusted to make the best decision for themselves and their families, according to their own unique circumstances that no one else can judge. Further, most Canadian women use contraception, although much could be done to improve access to the most effective methods. Unintended pregnancy can happen to anyone despite best efforts, because no birth control is 100 per cent effective and people are human and make mistakes. Abortion must be there as a safety net.

5. "The 100,000+ children aborted annually would pay at least $500 million dollars in income taxes alone after their first year of employment. This lost tax revenue would help keep dying government programs afloat like Medicare, Old Age Security, and Canada Pension Plan."

Women are not brood mares for the state. They cannot be conscripted to produce babies for economic or other reasons. Unfortunately for anti-choicers, Canadian women were declared persons in 1929, and gained equality rights and other constitutional rights under the Charter in the 1980s. The age of reproductive slavery that anti-choicers yearn for is never coming back.

The lament for the "100,000+ children aborted annually" makes plain the real goal behind their duplicitous "Defund Abortion" campaign -- to stop all abortions. But that's nothing more than cruel ignorance. If abortion was ever banned in Canada, women would still be having 100,000 abortions a year, only they'd be doing it clandestinely and unsafely. Those abortions wouldn't be reported or tracked, just swept silently under the rug along with women's misery, fear, suffering and deaths. Sadly, punishing women for having sex does seem to be what the anti-choice movement is really about.