Thursday, August 27, 2009

IVF Comment and Reply

In the comments section of my last post on IVF, Charles Anthony writes:
As far as I am concerned, the only people who should get IVF treatments are the people who pay for it all themselves.
(I'm guessing that this might be the same Charles Anthony who writes so ably at ThePolitic.)

I know that I have a tendency to be little long-winded (long-keyboardes?) in my blog posts, so it is useful to have people make succinct points that are right on target. On principle, I tend to agree with Charles.

I don't think, generally speaking, that the government should be funding IVF treatment, and I agree that people should pay for it themselves. However, in most "advanced" economies, the manner in which we tend to pay for such medical treatments is through insurance. In the case of Ms. Ilha and Mr. Attaran, the Ontario (and Canadian) government is working against them. With OHIP, we have so perverted the health care/insurance market, we have restricted access to this method of payment. If people are forced by law to fund and be covered by a public health insurance plan, it seems reasonable of them to expect that the treatments they need (loosely defined) will then be covered by that plan.

It's true that in Ontario we are allowed to buy supplemental coverage, but, again, the incentives in place discourage people from taking such action. If we view health care as "free" in Ontario (it isn't, but that's how people think of it), the rate of increase in the cost of health insurance when we buy supplemental coverage approaches infinity. That doesn't seem like a reasonable purchase. Further, we are tacitly saying to people, don't worry, the government will take care of all your health care needs. It should be obvious that it can't, but the signals in society lead us to another conclusion.

All that being said, I still can't come out and support this initiative to fund IVF treatments for all women under 42 years of age. What I'm saying in this post is that I don't see this as a simple question, considering the state of health insurance in Ontario. Thus, I'm willing to be persuaded to the opposing view.

However, if we look at the bigger picture, this issue should demonstrate that we are not the bastion of wonderful health care/insurance that we like to claim to be. We fail our citizenry in terms of treatment options and delivery times, and we fail our taxpayers by confiscating more and more of their wealth to bolster an inefficient and, sometimes, undesirable system. Perhaps if we were to move in the direction of Health Savings Accounts and more freedom and individual choice, we could work our system away from such dilemmas. It is possible to maintain sufficient health care for all through a public insurer, and still work in some components of the free market (not to mention freedom in general).

Unfortunately, in Ontario, we seem to have a love affair with our current health care system. Sober analysis never seems welcome.

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