ARCC’s position is that all abortions are ‘medically necessary’. The Canada Health Act identifies ‘medically necessary’ as that which is “physician performed”. It should not be left to politicians or religious leaders to determine what is and what is not medically necessary. Abortion is time sensitive and women must decide relatively quickly whether to continue or end a pregnancy. To classify abortion as elective causes unnecessary delays and increases the medical risk to women. Abortion is a constitutional right for women and women must be guaranteed safe and timely access in hospitals and clinics.
The current situation in which clinic abortions are covered by Medicare in some provinces but not in others is discriminatory and contravenes the Canada Health Act. The official position of Health Canada is that abortions must be publicly funded whether performed in a hospital or a clinic. Abortion clinics exist because not enough hospitals provide services and hospital access often imposes limitations on the service; clinics provide a medically required service. Abortion clinics can be compared to private doctor’s offices and should therefore be considered as part of our universal Medicare system.
Abortion must be included in provincial reciprocal billing agreements. The Canada Health Act guarantees portability of services so that Canadians can obtain medical care outside their home province. The provinces determine what services will be exceptions. The list varies from province to province but may include such services as cosmetic surgery, sterilization reversals; or acupuncture; unlike abortion these are not time sensitive services. To exclude abortion seriously affects women who are temporarily living away from home, such as students, or who have recently relocated to another province and do not yet qualify for health care insurance in their new home province.
ARCC is committed to ensuring that as abortion providers retire, there are trained professionals willing to replace them. We will work with other organizations, including Medical Students for Choice, to facilitate training and encourage doctors to become abortion providers.
While two-thirds of all abortions are done in a hospital and covered by Medicare, the availability of hospital abortions is disappearing from smaller communities across the country. ARCC will lobby the federal and provincial governments to improve access to hospital abortions, particularly in rural areas, by forcing hospitals to comply with the Canada Health Act. The lack of services in rural areas places undue physical and financial stress on women when forced to travel long distances, find accommodation, take time away from work and, in some cases, have to pay for the abortion themselves. For teenagers, victims of incest, or women living in an abusive relationship, the risks are much greater. Provinces must also comply with the Canada Health Act to ensure the availability of Medicare-funded abortions, whether performed in a hospital or a clinic.
Hospitals have a responsibility to provide all medically
required services. ARCC is concerned that today less
than one in five hospitals provide abortions, making it
difficult for women to access safe and timely abortion
services. The barriers to hospital abortions must be
removed so that women do not face discrimination and delays
that put their health at risk. Further, hospitals must
create a safe and confidential environment for both patients
Hospitals vs Clinics: Comparisons of Abortion Care
This paper compares some of the characteristics of abortion care in clinics to that of hospitals in Canada.