In Canada, almost all abortions are paid for by taxpayers. In British Columbia, Alberta, , Manitoba, Ontario, Quebec, and Newfoundland, abortion is paid for under the publicly funded system whether it is performed in a hospital or private clinic. In New Brunswick, hospital abortions are paid for by taxpayers but private clinic abortions are not. In Saskatchewan, the Northwest Territories, Nunavut, and Yukon hospital abortions are paid for by taxpayers but there are no private clinics. No abortions are performed in Prince Edward Island. The province does cover abortions performed elsewhere if they have been declared by a doctor to be medically necessary and have been pre-authorized and approved.
Under the Constitution, health care is a provincial responsibility. Provinces decide what services will be covered by the publicly funded health care system. In his March 2001 interim report on health care, Liberal Senator Michael Kirby, chairman of the Standing Senate Committee on Social Affairs, wrote that “the determination of what services meet the requirement of medical necessity is made in each province by the provincial government in conjunction with the medical profession.”
For provinces to receive funding from the federally-administered Canadian Health and Social Transfers, they must follow the guidelines of the Canada Health Act (CHA) which requires provinces to fund “medically necessary” services, but it does not define what those are and there is no list of specific services.
This was confirmed by Health Canada in response to an access to information request from MP Garry Breitkreuz. Health Canada replied: “This is further to your request under the Access to Information Act, dated August 1, 2001, for: documents, reports & correspondence in the department that provide evidence that abortions are‘medically necessary’. I regret to inform you that after a thorough search of all likely record holdings, departmental officials have confirmed that they have no records relevant to your request.”
Politicians sometimes say they pay only for medically necessary abortions but most do not require any evidence of medical necessity. Physicians simply submit the bill to the health care system for reimbursement. Only Prince Edward Island requires a specific medical reason for abortion to be covered by taxpayers.
In 2001, the president of the Canadian Abortion Rights Action League argued before the House of Commons Finance Committee (October 31, 2001) that, “Women who make the decision to abort a child at a certain point in their lives do so for socio-economic reasons. Sometimes, it is a desire to complete their education and become financially independent. In many cases, couples with children wish to restrict their family size in order to provide them with adequate financial support.”
Almost all abortions performed in Canada are done because a pregnant woman chooses to end the pregnancy for personal reasons, not medical ones. Medical necessity is rarely part of the decision.
What have the courts said?
Until 2005, no court in Canada had ever ruled that abortions must be publicly funded. In 2005, Winnipeg judge Jeffrey Oliphant ruled that the failure to pay for private clinic abortions was a“gross violation” of women’s rights. The decision was overturned in 2006 by the province’s Court of Appeal because the judge had not heard any evidence on the issues involved. An appeal to the Supreme Court of Canada was refused. The provincial government had already begun paying for all abortions in 2005 but not as a result of the court case.
In 2006 a Quebec judge ordered the province to pay the full costs of private clinic abortions. The province had been covering a portion of these costs. The provincial government complied without appealing the decision.
What does it cost taxpayers?
Since no level of government has released cost figures for abortion, we can only estimate what the direct costs of abortion are. (These estimates exclude any indirect costs, that is, costs for follow-up procedures for immediate complications and side effects, and longer-term treatments for associated post-abortion problems. See Elizabeth Ring-Cassidy and Ian Gentles’ book Women’s Health After Abortion: The Medical and Psychological Evidence, The deVeber Institute for Bioethics and Social Research, 2002).
We use the figure of $75 million a year, based on an average cost of $800 per abortion for 93,750 abortions. In 2009, the Canadian Institute for Health Information reported 93,755 abortions performed in Canada on Canadian women (the 2010 figure is 64,641, but that excludes Quebec). They admit that this is “probably an underestimate of induced abortions done in the
Country” because of reporting problems from some provinces and private clinics. Also, Clinic data for British Columbia is incomplete, and data on abortions performed in an Ontario clinic on Canadian women who are not Ontario residents is not included, so the $75 million figure is already low for the 2009 year.
Since hospital abortions constitute more than half of all abortions performed in Canada, we used an average of the $500 cost (at the low end) of a clinic abortion and $1000 (again, at the low end) estimate for hospital abortions. The $800 cost per abortion is in fact a very conservative estimate and the $75 million a year figure is probably an underestimate of how much taxpayers spend on medically unnecessary abortions.
Some published estimates on the cost of abortion:
- According to the Abortion Rights Coalition of Canada, “abortions at clinics are significantly more cost-effective than abortions at hospitals (mostly because hospitals tend to use general anaesthesia rather than local anaesthesia). The average cost for an early surgical abortion at a clinic is about $500, while the cost for the same abortion at a hospital can exceed $1000.” (Position Paper #2, June 2005, http://www.arcc-cdac.ca/postionpapers/02-Abortion-Clinics-Fully-Funded.PDF)
- According to the Vancouver Island Women’s Clinic: “Surgical abortion is covered by BC medical insurance (MSP). […] If you do not have BC provincial health insurance (MSP) but are covered by another Canadian provincial/territorial health insurance plan then the cost will be $500 to $1000 depending on how many weeks you are. […] If you do not have medical coverage from a Canadian provincial or territorial medical plan (e.g. foreign visitor or have no coverage) then you will be required to pay the full cost of the procedure which is $1800.” (What does it cost? 2012, http://viwomensclinic.ca/Cost.aspx)
- According to Joyce Arthur of the Pro-Choice Action Network (Pro-CAN): “The average cost for an early surgical abortion at a private abortion clinic is about $500, while the cost for the same abortion at a hospital can exceed $1000 […] “Hospitals have bigger bureaucracies and more overhead. Most use general anesthesia for abortions, while clinics use less expensive local anesthesia and conscious sedation. Abortion clinics deliver more ‘bang for the buck’ than hospitals.” Pro-CAN also mentions that “Abortions are significantly more expensive in hospitals. An early surgical abortion at a clinic costs between $450 and $550, while the same abortion at a hospital can be estimated at about $900 to $1200. (Abortion Clinics Are Better and More Cost-Effective Than Hospitals, November 29, 2002, www.prochoiceactionnetwork-canada.org/media/release-nov-29-02.shtml)
- According to Canadians for Choice, patients pay “between $500 and $750 for medical care”at the Morgentaler Clinic in Fredericton. (Jessica Shaw, 2006,
- Reality Check: A close look at accessing abortion services in Canadian hospitals, http://www.canadiansforchoice.ca /report_english.pdf)
Do taxpayers want to pay for abortions?
The opinions of Canadians toward the use of public funds for abortion have not changed much over the last several years. Only 30% of Canadians indicate that abortion should always be financed using a health-funded tax system.
Just over half of Canadians (54%) think abortion should be financed through taxes but only in case of medical emergencies, such as a threat to the mother’s life or in the case of rape or incest and 13% think that paying for abortions should be the individual’s responsibility. 64% of Canadians polled, therefore, do not support tax-funding of all abortions.
Note: The 2011 poll from which this data is derived, along with polls from previous years, can be viewed on the LifeCanada website (www.lifecanada.org) on their National Polls page at http://www.lifecanada.org/services/national-polls.
There were 13,084 abortions reported in Alberta in 2010, according to the Canadian Institute for Health Information. Taxpayers pay the full cost of abortions in the two hospitals that provide abortions and in the province’s two private, for-profit clinics.
The Canadian Institute for Health Information reported 12,149 abortions performed in B.C. in 2010. Taxpayers pay the full cost of all hospital and clinic abortions. There are five private abortion clinics in B.C and eighteen hospitals that provide abortion services.
There were 4,150 abortions reported in Manitoba in 2010, according to the Canadian Institute for Health Information. Manitoba taxpayers pay the full cost of hospital and clinic abortions. There are two private abortion clinics in the province and two hospitals that provide abortion services.
The Canadian Institute for Health Information reported 1,098 abortions in New Brunswick in 2010. Taxpayers pay the full cost of hospital abortions. They do not pay any of the costs of abortions performed at the Morgentaler Clinic in Fredericton, which is the only clinic in New Brunswick. Two of the province’s hospitals provide abortion services.
Newfoundland and Labrador
In 2010, the Canadian Institute for Health Information reported 1,068 abortions in Newfoundland and Labrador. Taxpayers pay the full cost of hospital and clinic abortions. There is one private abortion clinic in the province. Two hospitals in Newfoundland and Labrador offer abortion services.
There were 40 abortions reported in the NWT in 2010. Taxpayers pay the full cost of hospital abortions. Abortion services are provided at two of the three hospitals in the Territories. There are no private clinics in the NWT.
There were 2,125 reported abortions performed in Nova Scotia in 2010. Taxpayers pay the full cost of hospital abortions. There are no private abortion clinics. The Morgentaler clinic closed its doors in 2003. Four hospitals in Nova Scotia provide abortion services.
There were 100 abortions reported in Nunavut in 2010. Taxpayers pay the full cost of hospital abortions and the travel expenses to the nearest facility when referred by a doctor. The one hospital in Nunavut does provide abortion services; there are no private abortion clinics.
There were 28,765 abortions reported in Ontario in 2010. Taxpayers pay the full cost of hospital and clinic abortions. There are eight private abortion clinics in the province. 28 hospitals provide abortion services in Nova Scotia.
Prince Edward Island
There were 76 reported abortions performed on women from PEI in 2010. However, no hospitals in the province perform abortions. Women who want abortions must leave the province. Taxpayers pay the cost of abortions in out-of-province hospitals if the procedure is determined to be medically necessary by a doctor in PEI. These must be pre-authorized and approved.
Due to incomplete reporting to the Canadian Institute for Health Information, residents in Quebec who obtained abortions were excluded from the official 2010 abortion statistics. Taxpayers pay the full cost of hospital abortions and, since 2006 the full cost of clinic abortions. Seventeen hospitals in Quebec provide abortion services. Thirty-six clinics in Quebec provide abortion services.
There were 1,915 abortions reported in the province in 2010. Taxpayers pay the full cost of hospital abortions. Three hospitals in Saskatchewan provide abortion services. There are no private clinics in Saskatchewan.
There were 147 abortions reported in Yukon in 2010. Taxpayers pay for hospital abortions. One hospital in the Yukon provides abortion services. There are no private clinics in the Yukon.
Abortion Coverage by Region, 2010, National Abortion Federation, http://www.prochoice.org/canada/regional.html
Abortion Clinics Are Better and More Cost-Effective Than Hospitals, November 29, 2002, Pro-Choice Action Network (Pro-CAN) www.prochoiceactionnetwork-canada.org/media/release-nov-29-02.shtml)
Access at a Glance, Abortion Services in Canada, Canadians for Choice, http://www.canadiansforchoice.ca/Access%20at%20a%20Glance%20-%20Abortion%20Services%20in% 20Canada.pdf
CIHI,“Induced Abortions Performed in Canada in 2009”, Canadian Institute for Health Information, http://www.cihi.ca/CIHI-ext-portal/pdf/internet/TA_09_ALLDATATABLES20111028_EN
CIHI,“Induced Abortions Performed in Canada in 2010”, Canadian Institute for Health Information, http://www.cihi.ca/CIHI-ext-portal/pdf/internet/TA_10_ALLDATATABLES20120417_EN
Position Paper #2, June 2005, Abortion Rights coalition of Canada, http://www.arcc-cdac.ca/postionpapers/02-Abortion-Clinics-Fully-Funded.PDF
Karine Richer, 2008, Abortion in Canada: Twenty Years after R. v. Morgentaler, Library of Parliament, http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0822-e.pdf
Jessica Shaw, 2006, Reality Check: A close look at accessing abortion services in Canadian hospitals, Canadians for Choice,http://www.canadiansforchoice.ca/report_english.pdf
Standing Committee on Finance, October 31, 2001, Parliament of Canada, http://www.parl.gc.ca/HousePublications/Publication.aspx?DocId=1041080&Language=E&Mode=1&Parl=37&Ses=1
Tax Funded Abortions, 2012, Action Life (Ottawa) Inc. http://www.actionlife.org/life-issues/abortion/12-tax-funded-abortions.html
What does it cost? 2012, Vancouver Island Women’s Clinic, http://viwomensclinic.ca/Cost.aspx