The right to choose - and not pay

Peter
Peter Jackson
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It's a shame Ted Kennedy didn't live just a couple of months longer.

If he had, the Massachusetts senator - one of the most steadfast crusaders for universal health care - would surely have had a broad smile on his face this past weekend.

The United States has taken its closest step ever to embracing universal health-care coverage for its citizens.

It's a shame Ted Kennedy didn't live just a couple of months longer.

If he had, the Massachusetts senator - one of the most steadfast crusaders for universal health care - would surely have had a broad smile on his face this past weekend.

The United States has taken its closest step ever to embracing universal health-care coverage for its citizens.

By a narrow margin - only five votes - the U.S. Congress passed President Barack Obama's tangly and hotly debated health-care reform bill. Among other measures, the bill would expand eligibility for the existing Medicaid program and would forbid insurance companies from disqualifying private-insurance clients with pre-existing medical conditions.

But the most significant change, by far, is the establishment of a public option. Insurance would be compulsory for all but a handful of Americans, but the government-run plan would offer an affordable option and help temper skyrocketing premiums charged by private insurers.

Much has been made of a last-minute concession to exclude abortion from health-care coverage. It was a blow to abortion-rights advocates in the Democratic fold, and will draw criticism from pro-choice groups. But some counterchanges on that front may be achieved when the bill heads into the next round of negotiations and debate on the floor of the U.S. Senate.

Familiar issue

The decision to exclude abortion from public health-care coverage may seem a little foreign to Canadians, as well as to Newfoundlanders. But the issue was very much a hot potato here only 15 years ago, when the federal Health Department mandated public funding of abortions in Canada.

As local author Beth Ryan reported in an April 1998 piece in the Canadian Medical Association Journal, then federal health minister Diane Marleau ordered provinces to pay the cost of abortions in any clinic for which it was already covering the cost of doctors' fees.

"The minister was saying that if the province paid the doctors, it was recognizing the service as legitimate," Peggy Keats, then manager of the Morgentaler Clinic, told Ryan. "And they should be paying for it - all of it. (Instead), we had women paying for a health service that should have been covered by their taxes."

In fact, the province, under the premiership of Brian Tobin, defied the Health Canada edict for more than two years, opting instead to suffer a clawback of federal transfer payments equal to the cost of abortion services not being covered.

"The Newfoundland government was losing anywhere from $8,000 to $11,000 a month," Gerry White, then a federal assistant deputy minister of health, told Ryan. "Women were paying for the service at the clinic and that amount was being deducted on the other end by Ottawa."

Emotional debate

That the province would rather not have the money at all than cover abortions speaks to the emotional debate that surrounded the issue here - as it does everywhere.

When the Morgentaler Clinic first opened in St. John's in 1990, it faced vociferous opposition from pro-life citizens. St. John's city council even overturned an eviction appeals board decision in an attempt to drive the clinic from its LeMarchant Road premises.

Abortion will always be a political hot potato. Polls over the last 10 years suggest public opinion as to whether abortion should be legal is essentially split down the middle, although pro-lifers who demand an end to abortion in all circumstances are still in a minority.

So in the U.S., with its zealous right-wing Christian element, the lack of support for publicly funded abortions is hardly a surprise.

However, it's difficult to predict whether unfunded abortion will remain the norm in the U.S., even if it remains absent from the current health bill.

In Canada, it wasn't the will of government, but rather the persistent legal challenges of Dr. Henry Morgentaler and other advocates that won women the right to choose, and to receive, abortions without having to pay enormous fees out of their own pockets.

Peter Jackson is The Telegram's commentary editor. You can contact him by e-mail at pjackson@thetelegram.com.

Organizations: U.S. Congress, Morgentaler Clinic, U.S. Senate Health Department Canadian Medical Association Journal Health Canada

Geographic location: United States, Massachusetts, Canada Newfoundland Ottawa St. John's LeMarchant Road

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