Opinion: Opting out of national pharmacare robs Alberta women of reproductive choice

Published Apr 17, 2024 • 3 minute read

Colorful oral contraceptive pill both 21 and 28 tablets strips. Getty Images/iStockphoto Photo by areeya_ann /Getty Images/iStockphoto

Let’s talk about choice. What is a choice? A one-syllable word that holds enormous weight.

Choice offers freedom, a sense of control, and independence. Choices hold the weight to guide everyday decisions which subsequently shape our lives. Every day you wake up and make a choice. You make a choice to get out of bed or stay in bed, make your bed or leave it messy, brush your teeth (hopefully) take a shower, and make a cup of coffee (or not). In fact, the trajectory of your day and subsequently your life, is guided by micro-choices that translate to tangible outcomes. There’s power in choice.

So why don’t women in Alberta have a choice in making equitable decisions surrounding their own reproductive health? What happens if Jasmine gets pregnant and can’t afford to raise a child but lacks access to means to terminate her pregnancy?

What happens if Keerat isn’t ready to have children because it doesn’t align with her professional pursuits but she’s still financially dependent on her immigrant parents who don’t believe in birth control? What about 18-year-old Joanne who just had unprotected sexual intercourse for the first time, doesn’t have a family physician, and is worried about sexually transmitted infections and pregnancy?

Every day, thousand of girls and women are being stripped of their right to exercise autonomy over their health.

Strikingly, 40 per cent of pregnancies are unintended and result in significant public health and social costs. Direct health care costs alone are estimated to be almost $40 million in Alberta, which does not account for social subsidies or larger downstream social costs.

Alberta’s decision to opt out of the national pharmacare program not only puts our women and girls at risk of early mortality, but also perpetuates the historical trend of marginalizing women’s rights and freedom. It particularly puts our most marginalized and vulnerable populations at the greatest risk.

A recent study came out explaining how teen pregnancy is an indicator for early mortality, death before age 31. One teen pregnancy raises risk by 1.5 times while two or more teen pregnancies raise risk by 2.1 times. This eye-opening statistic is a predictor of women in vulnerable situations.

So why not take that vulnerability and change it into empowerment by offering choice? The cost of birth control is the greatest barrier to access. Providing free-of-cost contraception will empower people to make informed decisions surrounding their health, education, family and career.

Further, the majority of people make contraceptive decisions based on cost, rather than what best suits their health or lifestyle. With contraception coverage, people can choose the method that works best for them.

So what outcomes can we anticipate in pharmacare-positive Alberta? Fewer unplanned pregnancies, money saved for the health-care system, improved health options, improved gender equality and economic equality, to mention a few.

But above all, it would grant our women freedom of choice. Many other regions already subsidize universal access to contraception, in full or in part; including Ireland, U.K., France, Spain, Sweden, Denmark, the Netherlands, Luxembourg, Italy, and Germany. These countries have done so because the personal, public health, and social benefits far outstrip the costs.

In fact, programs that offer free prescription contraception have been found to be revenue-positive. This is because the cost of providing free prescription contraception is considerably lower than the costs associated with unintended pregnancy.

So next time you go about your day, I challenge you to be mindful of every choice you make. Count your choices and think of every woman in Alberta being stripped of hers.

Krittika Bali graduated from the University of Alberta with a bachelor of science and master of science in medicine and is a current medical student at the University of Limerick in Ireland.

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