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Canadian Medical Association Journal
April 7'98

Abortions now funded in Newfoundland

CMAJ 1998;158:860-1

© 1998 Beth Ryan

A recent decision by the Newfoundland government means women no longer have to pay for abortion services at the Morgentaler Clinic in St. John's. When the clinic opened in October 1990 it received no government funding. Instead, it charged patients a fee of $400 to $750 to cover the cost of the procedure. The clinic was able to reduce its fees in 1993 after the province agreed to pay the physicians who performed the clinic's abortions.

But lawyers for the Morgentaler Clinic argued that the province should pay the entire bill, since abortion is considered a medically necessary procedure that is covered by the Canada Health Act. Nothing happened until early 1995, when the federal health minister of the day tackled the issue.

Diane Marleau ordered provincial governments to foot the bill for services provided by private clinics in cases where they are already paying the doctors' fees. "The minister was saying that if the province paid the doctors, it was recognizing the service as legitimate," says Peggy Keats, manager of the Morgentaler Clinic in St. John's. "And they should be paying for it — all of it. [Instead], we had women paying for a health service that should have been covered by their taxes."

Provinces that did not comply with Ottawa's request by October 1995 were penalized because the federal government began clawing back their transfer payments. "The Newfoundland government was losing anywhere from $8000 to $11 000 a month," says Gerry White, assistant deputy minister of health (policy and planning). "Women were paying for the service at the clinic and that amount was being deducted on the other end by Ottawa."

After 2 years of reduced payments, Newfoundland decided to stop fighting the decision. In January the province announced it would cover the full cost of abortion services provided at the clinic. "The province is now in full compliance with the Canada Health Act," says White. "Abortion is considered an insured service, so women who go to the clinic can now use their MCP [health insurance] card.

For its part, the Morgentaler Clinic has eliminated its fees. "This is a province where people don't have a lot of money," explains Keats. "We've had women coming in here with income tax cheques, with their student loans, with whatever money they could come up with. That should never have happened."

So far, the only opposition to the decision has come from the Care Centre for Women, which is run by the local right-to-life association. The group has been writing letters to the local papers, condemning the government's change in policy.

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