Ah, Spring! When things come alive and nature reproduces in abundance. In Ontario, it also signals the possible start of election season, in anticipation of which Kathleen Wynne's Liberals are rolling out pre-budget announcements. Among them: a bet that new funding for fertility will boost their political fortunes.
At first blush, a policy that improves the chances of would-be parents to get pregnant seems like a compassionate one. There are countless heartbreaking stories of couples who find it difficult to conceive and struggle to afford the treatments that might improve their chances. Who would argue against helping them?
But the government's pledge to use tax dollars to pay for one round of in vitro fertilization for all infertile people is misguided. The cost is about $50-million a year. There are medically necessary treatments for harmful and even fatal conditions that are not properly funded. Should IVF treatment get priority over them?
At a time when health-care funding is stressed, offering an expensive treatment to a fraction of people for whom the chances of a successful pregnancy are minimal should raise questions. IVF is a pricey procedure – between $7,000 and $15,000 per cycle. Only 15 to 30 per cent of IVF cycles result in pregnancy. If the Ontario government wants to "help more people expand their family," as its press release states, IVF is a low-percentage play.
The government recognizes the cost argument – how can it not? – and so it also claims its new policy is fuelled by the desire to "reduce the health costs associated with multiple births." Couples paying for IVF often choose to have more than one embryo implanted during the procedure to improve their chances of pregnancy. Twins or triplets can be a welcome result for parents, but can also be a costly burden on the medical system.
Ontario appears to be emulating Quebec, which has covered the cost of IVF since 2010, but only for single-embryo births. The policy has reduced the number of multiple births. But funding IVF for single-embryo transfers is a roundabout way of regulating the practice of implanting multiple ones. That could be done regardless.
The government's motivations behind its new fertility-funding policy are all over the place. Expanding families, reducing the health costs of multiple births and investing in "people" are all noble goals. Publicly funded IVF guarantees none of these things.
Funding free IVF procedures for everyone would be wonderful in a parallel universe where medicare is boundless and capable of fully paying for any and all medical procedures, whether necessary or elective. But we live in a real world of finite resources, where we cannot say "yes" to everything. To govern is to choose. It would be nice if the Ontario government remembered that.