Health ministers responsible for reproductive health, too

Posted on June, 27 2018 by Action Canada

Op-ed published in the Winnipeg Free Press

What does it mean when a health minister attends an anti-choice rally?

Manitoba Health Minister Kelvin Goertzen was called out in the legislature recently for speaking at an anti-choice rally. He claimed to speak on behalf of his personal experience and dodged questions afterward. Why is this so concerning? Because he is the health minister.

While some will defend his right to personal or religious beliefs, they are not accounting for the serious responsibility he has as an agent of the government and the one person invested with the spending power to ensure or deny medically necessary services — including access to abortion and abortion-related care.

Yes, abortion is decriminalized in Canada, and has been for more than 30 years. And the creation of a criminal law would sit within federal jurisdiction, but many people in Manitoba and in the rest of the country do not have access to abortions. This is especially significant here, because addressing the barriers to abortions is often within the purview of the provincial health minister.

Manitoba is also one of the most difficult provinces in which to access abortions. Many seeking the service are required to travel upwards of 20 hours (on their own dime) to Winnipeg or Brandon, or leave the province altogether.

Easing access to the abortion pill (known as Mifegymiso in Canada) is within the minister’s jurisdiction and has the potential to positively impact rural and remote areas, but the medication’s cost is not universally covered by the province and remains out of reach for many.

The price tag of $350 to $450 is only one of the many costs that the minister could address. Travel, accommodation, child or family care and lost wages make it beyond difficult for many people to access abortion services that are only available in urban centres.

The pill’s cost is covered for all people in Nova Scotia, New Brunswick, Alberta, British Columbia, Ontario and Quebec, but not in Manitoba. Manitoba quietly added Mifegymiso to the provincial drug formulary last year, but unlike provinces where the medication’s costs are covered for anyone with a provincial health card, Manitoba covers only those with extended drug benefits through pharmacare, and only at two sites in Winnipeg and one in Brandon where surgical abortions were already provided.

The announcement also came from the minister of the status of women, not the health minister; he refuses to address the issue or say the word “abortion” publicly. His silence speaks the loudest. When the minister responsible for ensuring Manitobans benefit from timely and equitable access to health care doesn’t address abortion care and is observed speaking at an anti-choice rally, the question has to be asked: are the rights of thousands of people being violated by one man’s personal beliefs?

Canada’s provincial and territorial health ministers are meeting in Winnipeg this week. As a country, we now face a remarkable opportunity to better uphold each person’s right to health. And provincial and territorial health ministers, including Goertzen, will play a huge role in defining the scope of this strategy.

Cost coverage of drugs such as the abortion pill under a national, universal, comprehensive pharmacare plan is the only policy option that meets human-rights standards for all people, including for communities often marginalized or ignored in health-care systems. The absence of a national pharmacare strategy systemically discriminates against individuals on the basis of sex, gender identity, HIV status and migration status, among other factors, because the groups most impacted by gaps in drug coverage include women, Indigenous communities, trans and gender non-conforming people, racialized communities and those of lower socio-economic or health status.

While the Manitoba pharmacare program offers some compensation, it is intended for those whose income would be most severely impacted by high prescription-drug costs. There is little consideration of what it takes to access the pill for people outside of Brandon and Winnipeg.

It’s not just Manitoba — those who form our provincial and territorial governments across Canada have a proactive obligation to set aside personal and religious beliefs and consider the human rights of their constituents, including their reproductive rights, in advance of any health policy. Under international human-rights laws, governments are obligated to realize the right to health by progressively using the maximum available resources. In that regard, this province and this country are failing. The needs of too many Manitobans are left unmet, and Canada is the only country in the world with universal health care but no national pharmacare strategy.

The abortion pill is just one example of unmet needs in reproductive health care. Canadians have a narrower range of contraceptive options than people in other developed countries; the absence of universal pharmacare strategy restricts people’s ability to make free and meaningful choices about the contraceptive method that best meet their needs.

Health ministers are responsible for ensuring our reproductive health, and no personal or political beliefs should interfere with people claiming those rights. A national pharmacare strategy endorsed by provincial and territorial ministers is a step toward meeting that right and raising Canada up to the same standard every other country with universal health care already has.

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