Good policy or purely politics: free birth control?
Ontario's NDP aims to pit men vs women with free pill pitch
As Ontario’s provincial election gets up to (unofficial) speed, the leader of Ontario’s New Democratic Party is pitching free birth control for women. It’s unfair, Andrea Horwath says, that men can get vasectomies for free while women have to fork out $30 per month for prescription birth control pills.
Is this good policy or purely politics?
“People should not have to shell out $30 a month, every month for years on end, for birth control,” says Horwath in a statement.
The first indication this may be more about politics than good policy is Horwath’s use of the word “people” in lieu of the more biologically accurate “women.” Is this a dog whistle for those who insist women aren’t the only “birthing people” on the planet? Or, is this a recognition there may some day (maybe soon) be a widely oral contraceptive for men? My guess: the former.
When speaking to reporters, Horwath went further and juxtaposed the monthly cost of birth control medication for women with the fact vasectomies (largely for men, despite our genderless dreams) are covered under the provincial health insurance plan. As if this was an inequity imposed on women because they aren’t men. Is it?
As a matter of public policy, free birth control for everyone makes sense if the goal is to reduce the birth rate in Ontario. But, Canada’s birth rate is about 10 births per 1,000 people and has been on the decline for decades – dropping by about .75% annually. In 1950 we were birthing over 27 babies per 1,000 Canadians. The global average today is 18 live births per 1,000. Canada’s current death rate is just under 8 per 1,000 and growing annually by about 0.15%. At these rates, our population is barely growing – except through immigration. And, Canada’s population needs to grow in order for our economy to grow. So, our policy should aim to encourage making babies.
Unwanted pregnancies are a burden on parents and that burden falls disproportionately on mothers, who often must raise the children on their own. Society shares this burden because single parents are often unable to be fully employed, and therefore we all lose the benefit of their potential.
The healthcare cost related to unwanted pregnancies is largely the same as the cost of welcome pregnancies, so there is no policy incentive to treat them differently: more kids are better for society than fewer kids.
Is free birth control immoral? No doubt, some people will argue those who can’t afford or don’t want children simply shouldn’t have them. There are other ways to prevent pregnancy including condoms and abstinence. Interestingly, the people who preach abstinence to avoid unwanted pregnancy often also oppose abortion. Morals are fascinating, fluid and rarely logical. Most certainly, morals are not universal and good public policy should never seek to impose one morality on society at large.
Is the current policy sexist? Horwath implies it is: free birth control for men vs. a monthly financial burden “for years on end” on women. But, there’s more to it than that.
Rightly or wrongly, Ontario’s healthcare system provides universal coverage for most surgical procedures – but not for prescription drugs. So, vasectomies are covered under Ontario’s health insurance program. So are hysterectomies and tubal ligations.
Prescription birth control medications for women (and men) is not covered. Neither are insulin for diabetics, or anti-depressants and anti-anxiety medication for those with potentially fatal mental illness, or heart medications for those with serious cardiac problems. Virtually no pharmaceuticals are universally insured in Canada.
So the inequity between user-pay birth control pills and insured vasectomies has nothing to do with gender. It has everything to do with the way Canadian governments have structured universal healthcare. Horwath’s NDP routinely takes credit for Canada’s universal medicare system. If the NDP is responsible for the good parts of medicare, it must also be somewhat responsible for the fact it doesn’t cover medication.
If this was good policy, it wouldn’t be focused on birth control. It would be focused more broadly on all medication. Granted, the NDP has long advocated for universal pharmacare. But, if Horwath sought to provide an example of why prescriptions should be universally insured, there are far better examples where the prescriptions are life-saving rather than merely life-enhancing: heart, diabetes, mental illness medications, for example. Instead, Horwath singles out birth control – for which there are many non-prescription and more affordable alternatives. So, this is not about good public policy.
As a matter of politics, Horwath’s announcement is smart. She got our attention with it and provided ample fodder for talk radio, water cooler, breakfast table and pub debates. The first task of any politician is to get our attention. They have to do that before they can even start to persuade us of their cause.
Horwath also seeks to wrap herself in the flag of division by pitching this proposal as a men v. women issue. In a culture of victimhood, she seeks first to create a victim: women in this case. In doing so, she hopes to activate allies in the victimhood community, arguing she is the only candidate that truly understands their suffering. Conveniently, she is also the only female leader in the election. Her male opponents will be forced to agree or disagree with her suggestion that women are hard done by the status quo. So, this is smart politics.
Conclusion: The NDP’s free birth control proposal is purely politics.