Public Funding of IVF
In Canada, public funding for health care, including in vitro fertilization (IVF), is regulated provincially. Ontario was the first province to fund IVF, but since 1993 funding has been restricted to three cycles for infertility patients with double blocked fallopian tubes. Recently there has been a move to expand coverage. In April 2014, Health Minister Deb Matthews to "contribute to the costs of one cycle of in vitro fertilization (IVF) per patient for all forms of infertility to help people who cannot conceive children." Alana Cattapan wrote an for the Toronto Star about the expansion of this coverage, arguing that the aims of the program could be achieved without public funding, and that one cycle would not be sufficient to promote access to care. In October 2015, the that it would be implementing the new funding program, and the program would include restrictions on age () and the number of embryos to be transferred.
Public funding for IVF began in Qu茅bec in 2000 when the government implemented a tax credit for up to 25% (or up to $15 000) for eligible fertility treatments. In 2001 this was raised to 30% (or up to $20 000) and again in 2007 (or up to $20,000). was passed in 2009: as part of a provincial public health insurance program, the Bill included further funding provisions for IVF (and a large proportion of fertility services available in the province) as well as regulations pertaining to access. The stated rationale for this move was to reduce the number of high-risk multiple births (i.e. twins, triplets, etc.) by making eligibility for public funding of IVF conditional on the practice of single embryo transfer. In became the first Canadian province to publicly fund open access to IVF for both medical and social infertility. While reports have shown a significant drop in the rate of multiple births since the program was instituted, the have been substantially higher than anticipated.
In the the Qu茅bec Commissioner of Health and Welfare was mandated to produce an opinion on assisted procreation activities in Qu茅bec in order to assess the merits of the IVF funding program. The public consultation aimed to address clinical, scientific, ethical, social, legal, organizational and economic issues. Fran莽oise Baylis and Ryan Tonkens submitted concluding that it is neither wise nor fair to use provincial tax dollars to fund IVF [PDF - 139 KB]. In November 2014 the Qu茅bec government tabled , An Act to enact the Act to promote access to family medicine and specialized medicine services and to amend various legislative provisions relating to assisted procreation. This Bill aimed to drastically reduce Qu茅bec's funding for IVF. The province also announced that it would create an advisory body that would, among other things, promote single embryo transfer.
Other provinces have also instituted measures to provide funding for IVF. Since 2009 Manitoba has put in place a 40% infertility tax credit (up to $8000), without built-in regulatory conditions. In July 2014, the Government of New Brunswick implemented for one-time grants to fund 50% of certain fertility treatments (up to $5000), also without built-in regulatory conditions.
听
More on funding IVF in Canada:
Carolyn McLeod, Toronto Star, November 1, 2015
Alana Cattapan. Shared Values, TVO, October 26, 2015
Carolyn McLeod and Andrew Botterell, In Due Course鈥擜 Canadian Public Affairs blog, 2015.
Vanessa Gruben, Ottawa Citizen, October 11, 2015
Lana McCrea, McGill Journal of Law and Health, May 29, 2015
Katharine Browne, Impact Ethics, March 17, 2015
Fran莽oise Baylis, Impact Ethics, December 2, 2014
Fran莽oise Baylis, Healthy Debate, December 8, 2014
Pamela White, Impact Ethics, July 15, 2014
Audrey L鈥橢sp茅rance, Impact Ethics, June 19, 2014
Kevin Dougherty, Montr茅al Gazette, June 6, 2014
Angelica Montgomery, CJAD News, June 6, 2014
Commissaire 脿 la sant茅 et au bien-锚tre, Gouvernement du Qu茅bec, June 2014
Togas Tulandi & Lenora King, New England Journal of Medicine, 368:1948-1949,
Alana Cattapan, Impact Ethics, April 21, 2014
Lysiane Gagnon, Globe and Mail, April 30, 2013
Fran莽oise Baylis, Impact Ethics, June 26, 2013
[PDF - 163 KB]
Fran莽oise Baylis, The Mark, February 27, 2013
Fran莽oise Baylis, canada.com, July 13, 2012
Canadian Agency for Drugs and Technologies in Health, Issue 14 鈥� December 2010
Health Quality Ontario. Ontario Health Technology Assessment Series, 6(18), 2006.