Bill 80 - Free Birth Control Act - 2nd reading

CLAUDIA CHENDER « » : Madam Speaker, I would like to move second reading of Bill No. 80.

I would like to start by reading not my words but the words of someone I respect very much, Dr. Martha Paynter. She is known to this House. She is a professor at the University of New Brunswick and a nurse, and she is also the chair of Wellness Within, which is an organization for health and justice.

She says, "One of the most significant barriers to reproductive health equity in Nova Scotia and Canada is the cost of contraception. Providing free contraception results in significant cost savings and improvements in population health. Governments save between $7 and $10 for every dollar invested in contraception." I will table this in a moment.

Madam Speaker, we tabled this bill last year, and it is so important that in fixing health care, we address issues around health equity. In the last debate we heard the member for Richmond talk about working in an integrated health centre that was particularly for urban Indigenous folks in Toronto and how important that was.

We know that our health system is anything but equitable. There are some people who have better access than others, and there are some issues that are taken more seriously than others. In general, and we have heard this in this Chamber already, issues that affect women, trans, and nonbinary folks are lumped in with some others at the bottom of the list.

When we were researching this bill around providing free access to contraception, there wasn't actually that much data. Why? Because we don't really study women's health outcomes that much. It's the people who make the funding decisions, the people who make the educational decisions in universities.

This is not a core area of focus, but nonetheless, we know from the correlation of age, income, and use of contraceptives - as well as anecdotally from people like Dr. Paynter - how vital access to this is, and how closely linked it is to affordability challenges. I think we would all agree that two of the main issues facing us in this legislative session are health care and affordability. We believe that this is a bill that touches both of them.

Dr. Paynter goes on to say, "As a nurse providing abortion care, I see how patients return again and again because while abortion services are rightly publicly funded, contraception is not, and abortion becomes the only recourse." The cost to Nova Scotia taxpayers of an abortion procedure is roughly $2,000. Compare this to $400 for an intrauterine device that provides effective birth control for five years, or $30 for a monthly pack of birth control pills. Contraception is a wise investment.

While I think the disparity of the cost of providing a surgical abortion and the cost of contraception speaks for itself, it should be noted that that reduced cost of contraception is still out of reach for many women in this province.

Before we introduced this bill, we introduced another bill that created a zone of safety for reproductive health providers, which was passed with the support of all parties in this House. In the debate on that bill, we raised this exact issue, which Dr. Paynter brought to us.

At that time, the government of the day - now our colleagues in the Official Opposition - in fact, the former premier, Stephen McNeil, committed to looking at this issue, and looking at providing IUDs and publicly funded access to birth control. That didn't happen, but what did happen was that the minister responsible for the Advisory Council on the Status of Women Act and Minister of Community Services at the time committed directly to the Choice Clinic to fund those through the government.

We didn't get it covered with MSI, as is proposed in this bill, but we sort of got it funded through the back door. That funding stopped when this government took over. I think it's worth noting that we have actually taken a step backwards on contraceptive care at the same time that other provinces are taking a giant leap forward.

British Columbia, as many will know, has just announced in their Spring budget that they will be providing publicly funded access to birth control for all British Columbians. We really think that it's time that we follow this model. I think it's really worth saying that it's not just us.

In fact, there are so many organizations that are also advocating for this kind of coverage. We have some in the gallery with us today. I think they were introduced earlier. This is the Dalhousie Medical and Government Affairs Advocacy Committee from Dalhousie Medical School. We thank them for joining us. I have to confess that sometimes in politics things work out in interesting ways.

Completely independently of us calling this bill, they had started a letter-writing and advocacy campaign around our bill. We only just discovered this yesterday. I'll table a sample of this letter which Minister Thompson will receive many copies of in the days and weeks to come.

Essentially, they make the same arguments that we're making here. I just want to read the closing paragraph of their letter where they say, "I believe these changes are a step in the right direction that would increase access to contraceptives, improve health outcomes for our province, reduce stressors on the health care system, and foster an environment of care in Nova Scotia that will attract a generation of physicians."

So, Madam Speaker, we've talked about how this impacts health care. We've talked about how this impacts affordability. We're now hitting on another big piece of what this government has stated is at the core of their mandate, and that's physician recruitment.

In the last debate, we talked about collaborative care, and I think all members of this House acknowledged that this is how physicians want to work. They want to work in collaboration. They want to work together. They also want to work in a system where, as much as possible, people's health needs are met in a sensible, compassionate and efficient way, upstream. So whatever path they choose to pursue, they have in front of them the people who need to be there, and that population health is actually at the forefront of their mind.

This is a huge step forward - this would be a huge step forward in that. It's not just our friends in our gallery today, but there are some other organizations advocating for access to free contraception. You will have heard of these: the Canadian Paediatric Society; Oxfam Canada; Action for Sexual Health and Rights, formerly known as Planned Parenthood; the Canadian Association of Midwives; the National Aboriginal Council of Midwives; the Canadian Medical Association; and the Society of Obstetrics and Gynaecologists of Canada.

That's a pretty exhaustive list, I think, of the people we choose generally to listen to around health, and what we should be doing to act on health. I'll go back to the fact that British Columbia has just done this. Their program is estimated to cost approximately $60 million. That's the projection they've made. So if we take it on a strict proportional basis of what a program here would cost, that would be about $12 million.

I'll remind folks that this government had $1.4 billion - that's a lot of millions - in unexpected revenue this year. So $12 million almost counts as a rounding error with that much unexpected revenue. When we have pushed other things in this Chamber, we have gotten the response: our focus is on health care, our focus is on health care, our focus is on health care.

Our focus is also on health care. We believe that this is a small and relatively inexpensive way to improve health equity, to improve health outcomes, and to improve our ability to attract and retain physicians - particularly young physicians - and I think our ability to change in some ways the culture of medicine. That's what we actually should be talking about more in this Chamber when we talk about what ails our health care.

Part of it is that we don't have enough doctors. Part of it is our pay issues. But a lot of it is culture. We have a new generation of physicians coming in, and they need to be able to conduct business in the way that is consonant with their personal values. I think that from the advocacy we see from the Dalhousie medical students, this is exactly the kind of thing that they're looking for.

The cost of contraceptives, as I said, is a serious barrier for many people. It's an issue that impacts women, trans and non-binary people, low-income people, and younger people. These are the people who would benefit most from a free contraceptive program.

I believe my colleague, the member for Halifax Chebucto, the other day in this Chamber provided a robust definition of a what a targeted program is and isn't. This is a targeted program. This is a program that is targeted towards all the people whose health care needs tend to be ignored - or many, in any case. So it checks another box for this government.

I think I'll just take a moment and note that the status quo is that there is a patchwork of private and public insurance programs, as many will know. Some of them cover some contraception. Some of them cover none. Some of them cover all. But there are huge gaps.

There aren't that many statistics that we could find provincially, but nationally, 20 per cent of Canadians have inadequate or no drug coverage. That's why this is part of our push for a pharmacare program more broadly, and a way that this government could lead in efforts towards a national pharmacare program. One in three workers have no coverage. It's not just folks who are unemployed, it's that people by and large tend to be without coverage here.

We see the ways that government investment can make such a massive difference in these areas. Again, I'll shout out our federal party who have pushed for, and have now brought in, a dental care program for all Canadians. This year, we will have everyone under 18 and over 65 who make less than $70,000 a year in this province access to dental care. That's massive. This a step in that same direction - to make sure that people just have access to the basic health care they need, and that money should not be an issue.

Access to contraception is a reproductive and gender justice issue. It should be treated as a social public health cost. It should not be a cost that is carried by people who are able to get pregnant. I don't need to give a sex ed lesson in this Chamber. My kids are getting it now - they are disgusted. They would be horrified if I was talking about it. We all have some sense of the various ways in which babies are made. We all know that the people who carry the babies are the ones who disproportionately shoulder the burden, the cost, and the responsibility at conception right through to death, of the little people whom they make. So this is an equity issue.

This proposal is part of our party's work on advocating for reproductive and menstrual justice. I mentioned our bubble zone legislation. This is connected to our push for greater access to midwifery, free menstrual products, access to reproductive health services, and others.

Of course, we also need a national pharmacare program. We need a provincial pharmacare program. But right now, in this House, this government - with this somewhat unprecedented surplus - could do something that would make a difference in the lives of so many women, trans, non-binary people, and all Nova Scotians, in fact. So we urge them to do it. This is health care. You said you'd fix it. Pass this bill.