Give taxpayer-funded prophylactics to Canadian youth, doctors say
Published Thursday, May 9, 2019 5:50AM EDT
Last Updated Thursday, May 9, 2019 1:27PM EDT
A group representing thousands of Canadian pediatricians is recommending that young people get universal access to free contraceptives, including condoms.
Youth should have access to their choice of confidential, no-cost contraception, according to the Canadian Paediatric Society.
The CPS said the most straightforward way to guarantee this is to cover the cost of contraceptives for youth as part of provincial or federal health care coverage until age 25.
“When it comes to accessing contraception, costs and concerns about confidentiality are significant barriers for youth in Canada,” the society said in a statement.
“More than a quarter of youth who do not wish to become pregnant do not use contraceptives consistently.”
That’s why the CPS is calling on the federal, provincial and territorial governments to adjust their health plans to cover the cost of all contraceptives, including condoms, for youth.
Last year, the CPS recommended that long acting reversible contraceptives (LARCs) such as intrauterine devices or other implants, be the first-line contraceptive method for youth.
But young people interested in using LARCs are often put off by the high up-front cost, the society said.
"Women should choose their method of contraception based on what is right for them, not on how much they can afford to pay," said Dr. Giosi Di Meglio, an adolescent medicine specialist in Montreal and author of the CPS position statement.
“Many must pay out-of-pocket because they have no pharmaceutical insurance, their insurance does not cover the contraceptives they desire, or they wish to obtain contraceptives without their parents’ knowledge.”
The society said youth with access to private health insurance face an additional barrier, since the policy holder is usually a parent who receives a report for each transaction.
Any strategy that involves private insurers must guarantee that youth have easy access to private family insurance without the involvement or knowledge of a parent or guardian, the society said.
“We don’t encourage youth to keep information away from parents and strive to include families in health care decisions wherever possible,” Di Meglio told CTVNews.ca.
“Nonetheless, there are youth who do not feel comfortable and safe speaking with their families about sexual and reproductive health, and we don’t want them to choose a less effective form of contraception – or none at all – because of that.
“Ensuring confidentiality – when a youth desires it – is critical to providing competent, compassionate care.”
All Canadian provinces recognize the legal right of an adolescent to confidential care, provided he or she has the capacity to comprehend and consent to care (and is over age 14 if living in Quebec), the CPS said.
“We know that cost plays a significant role in the choice of contraception and the choice to use contraception,” Dr. Di Meglio told CTV News Channel.
“Cost is a significant barrier for all women and in particular for youth.“
The society cited a 2015 study that claims the initial public investment to provide no-cost contraceptives to all Canadian women would come back two-fold in savings related to the medical costs of unintended pregnancies.
The CPS supports the provision of free birth control for all women of reproductive age and estimated the cost for its proposal would be around $157 million to cover all Canadian women.
“It’s a lot less to just cover the 25 and unders,” Dr. Di Meglio told CTV News Channel.
Provincial health plans cover contraceptives for low income women.
Private health insurers don’t always include birth control and when they do, generally it only cover 70 to 80 per cent of the cost.