Federal Health Minister’s crackdown on private health facilities leaves abortion clinics untouched.

Early in January, two kinds of scandal concerning abortion clinics came to public attention.

Federal Health Minister Diane Marleau announced that she was cracking down on private clinics which charge “facility fees”; they might be the beginning of a two-tier health system, she said, in which the well-off can get medical services when the poor cannot.  So she intends to deduct a dollar in transfer payments to a province for every dollar charged through user fees.

Quebec, for example, pays a doctor’s fees for abortions, but clinics bill patients directly for so-called extras – nurses, counsellors, and medical tests.  These “extras” can cost from $175 to $500.  Alberta, the province chiefly targeted by Marleau, has a clinic in Calgary where the fees are $375 for women whose babies are not past 13 weeks, and up to $800 for women in the nineteenth week.

So that is the first type of scandal.  In four provinces – Alberta, Quebec, Nova Scotia, and Newfoundland – physicians’ fees are covered by medicare, but clinics are allowed to charge so-called facility fees.  (In Ontario, the extra fees are paid by the provincial government.)  The clinics turned out to be far more profitable than anyone imagined.  Become an abortionist and become a millionaire.

The second scandal, the scandal that Marleau did not mention, is that payments for abortion are coming out of the health funds in the first place.

In 1969, when Justice Minister John Turner brought in the legislation permitting abortion, he made three important statements about it.  The first was that the number of abortions was not going to increase; they were only going to be performed in hygienic conditions.  The second was that the decision on abortion was going to be solely a medical one; rejecting abortion for sociological and other reasons, he said it was to take place only when the health or life of the mother was in danger.  Third, when Dr. Rynard of Simcoe North asked whether abortion was going to be paid for out of “medicare hospitalization,” he gave a very definite answer: “Oh, no.”

Whether or not these statements were intended to deceive, they quickly became inoperative.  Abortions soared in number, they were rarely if ever performed because a woman’s life was in danger, and they were paid for by provincial health schemes.

Just before Christmas 1992, Ontario Health Minister Frances Lankin made public the report of a special task force on access to abortion in the province.  The committee had been carefully selected to produce a predictable result: its members were a Who’s Who of the abortion movement.  So Mrs. Lankin welcomed its recommendations – for more abortion facilities, the training of more doctors, more pro-abortion education, and so on.  She quickly revealed the extent of her own bias, and the distance between her thinking and that of Parliament in 1969.  “I care about this issue personally,” she said.  “I’ve spent a lot of time as someone who has promoted the right of the individual to choose.”  She emphasized that “women need to have access to full reproductive health services,” and that the province must insist that “access to this legal health service is a right.”

What legal health service?  She neglected the implications of the 1988 Morgentaler decision: when it struck down the system of therapeutic committees, it removed even the pretence that abortion had to be done for health reasons.  Henceforth it could be done for any of the reasons John Turner rejected, or for no reason at all, except a woman’s choosing it.

Without realizing that it was doing so, the 1992 report on access to abortion in Ontario made clear why abortion should not be paid for out of health funds.  The authors felt so strongly that a women had a right “to a full range of reproductive health care in her community” that it even advocated compulsion in ensuring that hospitals and health professionals be available to provide abortions.  Many proposals to this effect were set forth in a section entitled “Towards Comprehensive Health Care.”  Yet this section declared that “the delivery of all abortion services in Ontario must be based on the recognition that it is a woman’s right to choose whether or not to have an abortion.  What each woman chooses will depend on her life circumstances, values and goals.”

Health care, then, does not come into it; abortion will not depend on a woman’s state of health, but on factors which may have little or nothing to do with health.  Abortion is elective surgery, like the decision to have a face lift or breast enlargement or other form of elective cosmetic surgery.  The task force report is based on a contradiction: it would require the Ministry of Health, at a time when the cupboard is bare and real health needs are not being  met, to spend millions of dollars to expand the abortion programme, even though it is not a “necessary health service.”  (We have seen some of these millions spent on the Toronto clinics, whether or not these millions qualify as “facility fees.”)

The long list of the task force’s recommendations – 46 of them – are all based on a lie.  Abortion is not a health service, but a death service.  Where is the politician who is honest enough and courageous enough to stand up in the House of Commons or in a provincial legislature and point out that it is entirely wrong for health funds to be diverted from real needs and put in the pockets of Morgentaler and his like.