Abortion Must Be Publicly Funded
October 10, 2009 · By Jonathan McLeod
Abortion is legal. I don’t care whether or not people feel that it should be, if you live in Canada or the United States, it’s the way it is and we have to deal with it. Reading this exchange between Robert Gibbs and reporter Fred Lucas, I find myself unable to shake the inescapable conclusion that under socialized health care (of one form or another) it is the duty of the government to fund abortions.
If the United States begins subsidizing health insurance for individuals (a potential component of health insurance reform), and if individuals are permitted to choose their preferred coverage (or maintain their existing coverage), there is no way to keep public funds away from abortion. Even if the costing structure is set up in such a way that people will get no additional coverage for insurance that covers abortion, money is fungible. There can be no walls erected that ensure that public funds will pay for the part of the coverage that covers doctor visits and tonsillectomies, but private money will pay for the part that covers abortions. It’s ludicrous to think this is even possible.
Further, it would be wrong for the government to start dictating the terms of valid insurance coverage, such that a common and basic procedure like abortion would be excluded. If the government is going to take taxpayer’s money to create a subsidy, the government has no right to create disincentives to purchase that which an individual considers the optimal insurance coverage.
If the U.S. goes further than that and fully funds health care with public money (as Canada does) and if abortion is legal (as it is in Canada), then it is the responsibility of the government to fund abortions. To do less would be to fail the citizenry. Again, abortion is legal. The government has no business attempting to use a separate programme (health insurance) to do indirectly what they could not do directly: abolish abortion. Such legislative chicanery has no place in a thriving democracy. If pro-life factions wish to outlaw abortion, they must win the debate; they must not be allowed to game the insurance industry.
True, in Canada, people are able to purchase supplementary health insurance, but it is ridiculous to lump abortion in with paying for a private hospital room. It is, whether one morally opposes abortion or not, a legitimate medical procedure that individuals should be able to have covered by their primary health insurance. Further, with “free” health insurance, the rate of increase in the marginal cost of supplementary insurance over primary insurance approaches infinity. If abortion must be covered only by supplementary insurance, we are encouraging people to go without sufficient coverage, should they find themselves in need of an abortion. For a government insurance programme to distort a market to this end is offensive.
I am disappointed that neither the Canadian nor American legislatures are able to have robust debates on the topic of abortion. I think it is a detriment to the health of our respective democracies that so much policy is dictated by the courts. Nonetheless, I see little value in manipulating health insurance to achieve one’s goals regarding abortion.
P.S. I wrote a series of posts on the topic of publicly funding IVF treatment. I was conflicted, but came out against it – which seems a little inconsistent with this post. I think the difference is that with abortion the patient is seeking intervention to halt a condition that will affect their health/body, whereas with IVF treatment, the patient is seeking intervention that will cause a condition that will affect their health/body. It seems to me that this is a hair worth splitting.
So, abortions should be covered, but eye glasses and exams are not? If I can not get glasses under our government run medical coverage, I need to get a better insurance program, but abortions should be covered? Both are legal in Canada, only one is covered.
How about needles for diabetics who need them to LIVE, they are not covered, but free needles are given out to junkies. Explain that to me. Abortions are not necessary, they are as we have been told endlessly a choice. Why should I have to pay for some woman’s choice to kill her baby, legal or not?
Your argument is not logical.
Unless the abortion is required to save a woman’s life it should NOT be payed for with tax dollars. It has the same status as any other vanity surgery such as face lifts and liposuction.
You think Abortions are so necessary to a thriving democracy then I suggest that you and your like minded ilk get off your collective butts and set up some sort of charity or resource like planned parenthood that will raise the funds so those poor women can have one at their choice and whim.
How about the public funding of circumcisions in infants?
That’s not presently covered in Ontario either (along with the eye exams, etc.)
Hunter – I don’t like the fact that eye exams aren’t covered. I think I would make similar arguments about funding eye exams as do about funding abortion. As to the rest of your post, I’m not sure why your non-sequitor makes my post illogical.
C-Mom – the whole “medically necessary” condition on abortion doesn’t work. We have seen this in jurisdiction after jurisdiction. If abortion is only legal or only funded if ti is “medically necessary”, suddenly all abortions will be considered medically necessary. Let’s not do that dance again.
I never said that abortion was necessary for a thriving democracy. I said that in a thriving democracy we should be able to have a serious political debate. Most pro life people I hear agree with this.
If we are going to socialize medicine, why must one specific procedure require charitable funding? Simply because you don’t like it?
Joanne (T.B.) – Routine circumcision (ie, the moment after birth), should not be covered. At the risk of contravening my response to C-Mom, it is not medically necessary, the patient has no agency and it has more negative ramifications than positive. I would make a similar argument about routine cosmetic circumcision as I do about IVF treatment in the Post Script in my post.
If a medical issue has been determined, then, sure, it should be covered.
If it is for religious reasons, I see no reason for government funding.
If we are going to socialize medicine, why must one specific procedure require charitable funding? Simply because you don’t like it?
Well we could start with that over 90% of these procedures are NOT a medical necessity, they are elective surgery. I do not appreciate taking the food out of the mouths, the cloths off of my children’s backs. reducing the funds I can put toward their education just so we can fund her scooping her inconvenient child.
And the risk you took? Your right it contravened, no question.
I happen to agree with you on IVF, it should not be covered by tax dollars. I totally disagree with your rational.
Not being able to fertilize an egg and carry it to term is not a RIGHT, it is a want. Just because we happen to have technology does not mean that society is obligated to give it to you for free. Pony up with your own cash or adopt, there are plenty of slightly older children languishing in foster care. To insist that any child of your own HAS to be of your own Gene pool should auto discount you as parent material.
Thanks, Jon. I never thought of that one as a good argument against socialized health care or socialized anything for that matter.
Abortion is only medically necessary in ONE scenario, and that’s when the mother’s physical life will be jeopardized if the pregnancy continues.
Most “pro-life” proponents, while not desiring that any child be lost, are able to accept publicly-funded abortion in that scenario.
All other abortions are elective and unnecessary. The Public should not have to pay for it.
Tax money belongs to the people. If they find abortion reprehensible, they don’t have to fund it. Most Americans don’t want it funded. Therefore it shouldn’t be.
Pregnancy is not a disease. Pregnancy is the result of health. If you have sex and get pregnant, it means your bodily functions are working as they should. If you cannot deal with that responsibility, don’t have sex.
Abortion is a solution to a social and personal problem, not a medical one.
Abortions are done by doctors because once upon a time they were the only ones who had the know-how to do them. That’s why they’re part of the medical system, and that’s why they’re considered “treatement”. Your typical abortion is about as much a treatment as your typical plastic surgery.
If I did not know better, I would think you’re trying to make a conservative out of me.
The irony here is that the argument in Roe v Wade is that the right to privacy is significant enough to encompass a woman’s decision to terminate her pregnancy (loosely lifted off wiki).
On other topics, conservatives will vehemently fight for the right to privacy and condemn any intrusion of the state on a person’s private life.
I also can envision a conservative echoing your stance simply because there is no single rallying call more powerful on the conservative right than that of the anti abortionists.
This call is exploited by atheist conservatives towards religious followers and is even heeded by religious liberals (I personally oppose abortion).
So articles like this almost seem like attempts to stimulate conservatives against a given subject.
By declaring abortion fit to be funded by the state because it is legal, you likely just get people to to protest it’s legality more and more.
The category “medical necessity” is nebulous, especially when trying to determine which individual procedures will be covered by public health insurance. In application, it is next to meaningless, for if we decide only abortions deemed medically necessary will be covered, then all abortions will be deemed medically necessary. We have seen this in Canada. We have seen this in various states in the U.S.
Further, the notion that doctors, bureaucrats and politicians should be deciding what sorts of procedures are acceptable turns my stomach. A patient/consumer driven decision-making process is far preferable and far more in line with a liberal democratic society. Canada isn’t a technocracy, and I hope it never becomes one.
To claim that tax money belongs to “the people”, and so they shouldn’t have to fund abortion ignores the fact that those who seek abortions may well pay taxes, too. These people have no choice about their primary care insurance (in Canada), and they have no legal method of backing out of the publicly funded model. The government (and, perhaps, the majority of “the people”) is acting a bully by forcing people into a health insurance system and then refusing to offer sufficient coverage. Granted, this is, perhaps, more an argument against socialized health insurance, but, until we address that, we’re in the wrong for doubly enforcing our will on others.
We are in a bind with government provided health care. If we decide that we have to provide coverage, then we have to realize that procedures that are viewed as unnecessary or immoral may well get covered.
(Besides abortion, some – like me – dislike funding elective c-sections, some might object to funding blood transfusions, some might object to funding procedures that do not add sufficient QALYs for the price that is attached.)
If we decide that we will greatly restrict the procedures that the government will fund, and that we will force people to receive only government insurance for primary health coverage, then we discount the value of the individual compared to the value of the collective. We further devalue individuals if we set up such a wealth-destroying system and then tell them that if they haven’t sufficient wealth, they have no right to other medical procedures. The tyranny of socialism is not only that which is imposed but that which is lost forever.
Hi RD,
I would never try to make you a conservative… I’m not that mean :)
I find the right to privacy is something that will be trumpeted by people all along the political spectrum when it serves their purposes. A lot of conservatives are fairly consistent with that, but others are okay with big government if it is conservative big government (I’m not claiming anyone around here is like that, and I’m not really thinking of abortion, either – maybe things like the PATRIOT Act).
I knew that my post could be read as me trying to stir up the conservative base against either abortion or socialized health care (or both), but that wasn’t my intent. I was writing about the imperfections of our society, and concessions that have to be made.
I note my personal opinions on abortion (very briefly) here (I’m rather squishy), and I think we have to have a certain amount of government involvement in the funding of health care (though I’m not a huge fan of the Canadian system; I’d like to see us move towards PSAs). I don’t like the fact people will have to, indirectly perhaps, fund abortion against their will, but until we find another system that satisfies the needs that I feel must be met, it is a trade off I’m willing to have the government impose on people.
haha,
I have to say that I am also squishy on the subject of abortion. I’m not for abolishing it but my position would always be to encourage someone to have the child. I’m a father of 2 after all.
It just goes to show how complex a political makeup can be.
One one hand, funding a daycare is a bad thing but on the other, funding abortions is ok. I’m not looking to re-engage on an old topic, I’m merely pointing out the complexities.
I think if any funding were to go to abortions, it should only be to subsidize the procedure, not to pay it in full. There’s also a question of personal accountability in a procedure that is not medically necessary and having an abortion covered under medicare is difficult to accept.
RD, yeah, sorting out a political philosophy is pretty complex – especially if you have to deal with issues subject to parameters that you might not agree with.
I guess my post came down to an attempt at trying to manage various imperfections. It can be a tough balancing act, and a lot of it will depend how we weight different concerns and interests.
I stand by what I wrote, but I’m open to persuasion to re-evaluate the situation. Politically, I’d be open to certain compromises, if it didn’t do too much harm. Thankfully, I’m a blogger, not a politician…
a very compelling argument indeed. your logic is sound.
i agree that abortion should be legal, that it is the right of the individual to the decisions that affect her body, but what bothers me about a taxpayer funded abortion is the fact that the risk element (monetary meaning, not medical) is not present. therefore you have many unfit or too young girls having babies with little consequences which leads to structural welfare dependancy and in alot of cases, single parent homes with low moral and ethical standards.
i believe the whole abortion issue could be greatly advanced by first, refusing to pay for such a procedure (though i note your legal quagmire above) but also to refuse the extra money paid to single mothers with kids versus ones without. i think if there were enough freemarket obstacles these teenagers and ill-fit parents-to-be would think twice. not a cure-all policy but one i think that would cut down the need for said abortions substantially.
Hi Brad, I hear where you’re coming from, and I respect the logic of your argument. However, I must disagree with the practical implications of your proposal.
I do not think tinkering with the welfare system and health insurance will make teenagers avoid risky sexual behaviour. I doubt it would enter into their calculus on a hormone-fueled Saturday night. I can’t see your proposal reducing unwanted pregnancy.
Consequently, my concern is that your proposal would hurt the children of unwed teen mothers the most. The whole situation is a big mess, and we have layers of welfare that may contribute to the mess, but I’d want to avoid policies that would do too much harm to children.
Jonathan, I was hesitating on whether or not I should weigh in on this, but I’m going to dip my 2 cents in anyway.
For the record, I’m “squishy” too. However, I find myself falling on the “elective” side of the argument. The following is simply my opinion, and I don’t claim it to be fact.
Pregnancy is a natural function of a healthy body. An unwanted pregnancy (presumably the basis for wanting an abortion) is not a medically necessary event given that in the vast majority of cases, carrying the child to full term and subsequently giving birth will not put the mother’s life or health in jeopardy; by which I mean that the life of the mother will not be lost (death) by doing so.
This then becomes an elective issue either because it is unwanted, inconvenient or embarrassing. Under such circumstances, the final “medical health” of the individual is not put in direct peril and therefore the “state” should not be responsible for covering this procedure.
The Canada Health Plan was created to ensure that all Canadians can receive critical medical care even if they do not have the ability to pay for it. Critical meaning care and treatment necessary to save the life of the citizen. An abortion does not fall under this category except in the extreme and rare case.
Over the years, we’ve added things to the system under sometimes weak arguments. This has allowed Canadians to come to believe that a watered down version of the original intent of the Plan is it’s true intent, and this is what has turned the Health Care System into the financial sinkhole it is.
As for the morality of certain medical procedures, I do not believe that it is the responsibility of the “state” to dictate what is moral and what is not. The “state” (just like justice) should be blind. Morality is the purview of the faith communities and it should remain there. The separation of Church and State in this situation is so important in my mind. If the faith community isn’t able to convince enough of their “flock” against the activities and circumstances they stand against then that, quite frankly, is their problem.
It’s their responsibility to sell their message to the people who in turn (if in great enough numbers) can influence law through the democratic process. It is not the responsibility of the state to create law just because the faith community failed to convince.
And also, for the record, I do understand and recognize that a woman’s body goes through certain medical and physical changes as a result of pregnancy and birth. That IS medical fact, however I also recognize that this doesn’t directly put the woman in mortal peril.