Thursday, April 24, 2014

The Business of Morgentaler

It will be virtually impossible to take a look into the effects of the loss of the Morgentaler Clinic in Fredericton NB without wading into the Pro Choice / Pro Life debate, but I hope that I can stand as clear of this debate as possible and suggest a more solution focused approach to this situation.

Yes, I am Pro Choice, so that is out of the way. Do I carry pickets, or preach my believes at social gatherings - nope. I am Pro Choice, and one of the choices of my belief is that I chose not to try to influence or simply care of what others position on abortion is. As personal as the decisions are around abortion, my reasons, my justification (so to speak) are just as personal. Kinda wish both side of the debate had this philosophy.

OK - nuff on that.

With the recent closure of the only abortion clinic in Atlantic Canada we are now in a bit of a dilemma. Abortion is legal, and if deemed medically necessary by TWO physicians - abortion is available in the safety of state of the art medical institutes and paid for by our Medicare system. Previous to the closure, Abortions were available at Morgentaler's Private Clinic for $700 - $850 (depending how far along the pregnancy is)

Aside from the moral endless debates - this seemed a pretty good solution. Non approving taxpayers were not burdened with financing non-medical related abortions, and medically necessary (with approval checks by 2 doctors), were treated like any other necessary medical procedure and paid for from public coffers.

I suggest that a out of pocket cost of up to $850 was a pretty solid deterrent for being completely oblivious to the chance of unwanted pregnancies - a box of condoms, or other forms of birth control comparably are a much cheaper and less uncomfortable option. But, for those cases that a pregnancy is unexpected or unwanted, the cost was not beyond reach for young couples, but would certainly be a financial punishment for being irresponsible.

I will not address the availability of the 2 doctor approved medical availability of abortions as that has checks and balances and is unchanged before and after the closure of the Morgentaler Clinic.

So where are we now? The only option for private abortions is a trip to Montreal - which now upsets the balance of reasonable financial pain, to encourage responsible birth control. It now becomes so cost prohibitive that several unsavoury consequences may be in the works. Self administered abortions are not unheard of for desperate couples, desperation for finding the money to now afford a trip to Montreal that could run well beyond the financial means of young couples. Or (yes this is debatable) the fact that couples will have babies that they do not want, and are not mentally, financially or mature enough to raise. Yes, Adoption is an option.. that unfortunately looks much better on paper than actually applies in real life - but I will leave that for another article some day.

My interest in this situation is one of economics.. a service that is legal, and required, is artificially overpriced by the now cost of travel.. that is will have significant ripple effects on the health and well being of young couples. So what is the solution??

Clearly the clinic was not financially viable to remain in business (like any other business), so how can that be resolved? An interesting business challenge.. not a simple supply and demand as it is so influenced by others that do not agree with the service, it is not a luxury that can simply find a price that the business can exist profitably, as there are couples entire lives at stake.

In situations that a (health and wellness) product or service must exist at such a high cost to maintain the providing business, our socialist (small "s") government typically steps in to make it available to all levels of financial status. But, and I respect the Pro Lifers on this, they do not want their tax dollars spent on providing a services that they are so morally opposed to.

Yet to add to the challenge, to reduce cost to to patients, again, supply demand would require a higher volume of business, which, whatever side of the fence you stand on this debate - is not a positive option.

As far as I can determine, (and I look forward to being corrected) - a clinic with a reasonable priced service, must be subsidized by an outside investor. Which should not be the government, It would required a clear understanding of the required, reasonable profit margins to operate this clinic, determine the shortfall of revenue based on historical traffic - and find funding to augment the shortfall.

Maybe the Pro Choice group would be better served by organizing and fulfilling this financial shortfall to make safe abortions available, and spend less time screaming at Pro Lifers and attending rallies. As Pro Lifer's make lots of noise - Pro Choicer's can quietly go about their business of raising money, and making local couples indeed have a choice.


  1. This is a topic I try to stay away from.. My husband and I are pro-life, but at the same time, I personally have no right to tell a woman what she can or can not do with her body. For me, the day i get pregnant, it means that I am a mom, that I have a baby... that's how we view it. I have seen two unplanned pregnancies in my family, one baby was kept and the other adopted, and the adopted child is till involved in our lives. It turned into a miracle for another couple who can't have children of their own. That's not to say it was an easy choice or right for anyone.

    An issue which needs to be looked at, why are there unplanned pregnancies in the first place??? Condoms are easy to get, birth control is easy to get and both are affordable. I made the choice to have an IUD put in, it's expensive but my health plan covered most of the cost, which I know I am fortunate enough to have. Before that though, I took the pill. I did not want an unplanned pregnancy, I was responsible and took it daily. If someone is so irresponsible with their own lives that they can not take a pill once a day, what the hell do they think they are doing having sex. No protection means risk of pregnancy.. I know the cost of protection and its common sense which one will cost more, pills or a baby.. I just don't see why there are unplanned pregnancies when there is no need for it.. I had my fun and slept around when I was younger, and I always used protection. No STD and no baby.. it's not hard..

    This clinic has been struggling for years, the owner was fighting for rights for years. Where was all this support when the clinic's owner was alive and fighting for these "rights". If it is such a concern for women then why weren't these women doing anything before? Now the clinic is closed and now your going to have a voice? Maybe the clinic would be open if people fought for the clinic beforehand.

    1. Thank you for this well composed comment - and I too was hesitant to delve into this topic, but my attempt (be it successful or not) was not to focus on the morality or right or wrong of abortion, rather the economic effect on the decision making. As you are pro life, I believe that you would like the decision to keep or abort an unwanted pregancy based on your morals and beliefs, not on a cold economic basis. And in this area, I suggest that we have common ground. I echo the fact that this life changing decision should be based on the couples ethics and morals.. NOT on a financial basis. So the fact being that regardless of pro life or pro choice "winning" in any debate on this.. and knowing the fact that abortions will happen, how do you think we solve the safe and accessibility of this procedure. As again, common ground, I am sure we both agree that the health of the mother is paramount.. and forcing decisions based on wealth is not a basis that this decision should be made on. Thoughts?

  2. Well for starters I think that in some situations such as rape, a woman should not have to get two doctors approval.. but at the same time... if that was the case, how many women would then cry wolf to get the abortion? I think we need to address the problem before an abortion is required.. make sure young women especially know how to get birth control and condoms. When I was younger i tried to go to the sexual health clinic because I was worried my parents would find out about me getting the pill, they turned me away because I had a family doctor. They also turned me away when I needed a PAP test because I had a family doctor, who was away on vacation and at the time, it was extremely important that I got checked out right away. The clinic was also never open when I went, even though it advertised that it would be.. If they would work on making the sexual health clinic more accessible and allow more access then maybe we wouldn't have as many unwanted pregnancies... Knowledge is power! I knew what would happen if I had unprotected sex, and if there were things about sex that I didn't know, I looked into it. I don't know how to solve the problem for safe access now.. this is something that should have been fought for, before they closed down, because to me, it shows that no one really cared until that option was gone, if it was that important, why wasn't anyone fighting for them when they needed the help? So moving forward... there should be no unwanted pregnancies... use a form of birth control, there are many and use multiple if you need to (condoms and the pill).

    1. I know topics such as this draw intense emotional commitment to ones belief.. and I think that commitment to a "side" in this discussion makes it very difficult to step back and look at challenges in "bite size pieces".. as I am tying with this article. An interesting thing I am seeing on both public and private comments - is that there is actually quite a bit of common ground between the Pro Life/Pro Choice groups. I think both agree 100% that there is a wish for no unwanted pregnancies, but I am afraid that will never become a reality.. all of the issues and observations are valid, but we cant just stand on a want that "there should be no unwanted pregnancies. I do ask, that (right or wrong) if there is an unwanted pregnancy and abortion is the choice for the woman.. should her financial status be the deciding factor in her decision..