Is infertility a disease? Is access to free in vitro treatment a human right? If you live in Quebec, the answer is yes to both.
Next month, the Quebec government will start funding in vitro fertilization for people who can't conceive normally. The infertility lobby is ecstatic. So is TV personality Julie Snyder, mother of two adorable in vitro-conceived kids (and wife of one of the province's richest men, Pierre Karl Péladeau). She's the poster mom for making fertility treatment an essential service. "There are some people who can only afford one treatment, so you cry with them," she said. "It's deeply unfair. I promised God that if I had my baby I'd do my best to help others."
It may, indeed, be deeply unfair that Celine Dion can spend a zillion dollars to get pregnant with high-tech twins and you can't. Yet, millions of us manage to cope. Many things in life are deeply unfair, and infertility is just one of them. And somehow we survive without the government to help us. Meantime, record numbers of people are embracing childlessness out of choice. It seems that one person's deep unfairness is another's blessed liberation.
In Quebec, demographics and politics go hand in hand. And pandering to the baby lobby is just one of the government's motives. The other motive is to bump up the birth rate. The government hopes that all those extra IVF procedures will add another 2,000 babies a year (mostly francophone). And that's not all. Now that IVF has been deemed a medically necessary service, the government has decreed it will no longer be available privately. Those who wish to pay for it themselves will have to go out of province.
As a result, doctors predict, the system will soon be overwhelmed. "Medicare can't cope with many areas of medicine," said Seang Lin Tan, chief obstetrician at the McGill University Health Centre. "The price we pay for free treatments is waiting lists. It will just be more of a burden on the system if we eliminate private treatments."
Like $8-a-day daycare - Quebec's last ingenious scheme to boost the birth rate - this one amounts to a blank cheque. The province will cover a wide range of treatments, including three rounds of IVF at $7,000 to $15,000 a pop, and its program will be the most expansive in the world. Single women and lesbian couples will be eligible for free sperm donations. IVF will be offered to people who are already parents, as well as to older women whose natural fertility has fallen off a cliff. By contrast, all other countries that offer IVF impose strict treatment limits. (Germany pays only half the cost.)
By 2014, the new program is expected to cost nearly $70-million. The Health Minister says it will pay for itself because state regulation of IVF will cut down on the number of implanted embryos and, therefore, on the number of multiple and premature births that cost the system millions. This is now the standard argument used by advocates who want other provinces to cover fertility treatments. But critics point out that ovarian stimulation, not IVF, is the main cause of multiple pregnancies. And as the number of IVF pregnancies soars, the cost of IVF-related problems will soar, too. There's also no new money in the health-care budget to pay for extra nurses, obstetricians and neonatal units.
Many argue that free infertility treatment is a human right. Some are even arguing the case before the Ontario Human Rights Commission. God help us if they win. The trouble is, free treatment costs a lot of money. The burden of Quebec's expensive new entitlement program will be borne by all those people who really do have diseases. Quebec's health-care system is already strained to the max and, by international standards, it's pretty lousy. What about our deep unfairness to them?
Julie Snyder may have kept her promise to God. But let us pray that other provinces don't cave in.