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Current Events: British Columbia to provide free contraceptive pills. But why?

Originally published on Mar 18, 2023


Finance Minister Katrine Conroy of British Columbia announced that the provincial budget for 2023 includes funding of $119 million over the next three years that will allow full coverage for prescription contraception. This makes B.C. the first jurisdiction in Canada to make birth control pills free for all residents. Currently, a prescription of contraceptives cost around $25 per month and the province said that the new free plan could save up to $10,000 over a person’s lifetime.

But why has the B.C. government decided to allocate funds for this initiative? Not only has actual government expenditures in recent years almost always exceeded planned budgets, but the Fraser Institute also shows that government debt has reached $55.8 billion. But even if the government has the money, why, when the province is facing health and housing crisis, did the government choose to include contraceptives?

Though the province mentioned supporting reproductive rights, increasing affordability, and improving health outcomes as the purposes of this initiative, it is more likely that the province is hoping to reduce long term health and childcare costs incurred by unplanned pregnancies (UP). According to the Guttmacher Institute, of all pregnancies in Canada between 2015–2019, over 46% were UP and 17% of all pregnancies ended in abortions. Furthermore, there has been a 22% increase in UP since the 1990s and women between the age of 15–24 have the highest rates of UP. Currently, the average maternal age at first birth in Canada is over 30 years old and still increasing. This means that women spend most of their reproductive lives at risk for UP, yet only 65% of Canadian women who are at risk of pregnancy and not trying to conceive always use contraception.

UP, however, are costly not just to women, but also to our society. A study in Canada puts the direct cost of UP at over $1200 CAD, and another study in the State of New York shows that costs associated with teen child bearing, including child welfare, lost tax revenue, and medical spendings reached $377 million USD a year. Child from UP are more likely to suffer poverty and teenage pregnancy, less likely to finish high school but more likely to be incarcerated. Every $1 spent on contraception, anywhere from $4 to $7 of taxpayer money be saved. In 2018, B.C. announced its historic $1 billion investment to be distributed in the following three years. In every annual provincial fiscal plan between 2018–2022, childcare was one of the key subtopics of the document and the term “child” saw mentions between 168–244 times. In 2023, however, childcare benefits no longer occupied a subsection in the executive summary and the term “child” was mentioned only 116 times. This hardly means that the province is reducing childcare benefits. In a document of future planning purposes, this clearly demonstrates that the province is hoping to shift away from expanding their expenses in childcare, and instead invest more in health care and affordable housing, which saw new investments of $6.4 billion and $4.2 billion respectively in the new 2023 budget.

In a world of decreasing birth rates, however, promoting contraception seems to accelerate the aging of the population and facilitate a crisis that overshadows savings in taxpayer money. Statistics Canada has been observing a falling fertility rate in B.C. for the past 13 years and, in 2020, B.C. recorded the lowest fertility rate in Canada at 1.17 children per women. Not only is it far below the rate of 2.1 children per women needed for the 1:1 replacement of population, it is also below the average of Canada (1.4). To offset the aging population, B.C., and indeed all of Canada, has decided to rely on immigration to fill the gap. B.C.’s population growth accelerated from 2.4% in 2021 to 2.8% in 2022, while Canada’s total population grew 1.4%. Since the early 2000s, there has been a steady increase in the number of immigrants entering Canada and in 2022 the federal government welcomed over 430,000 new immigrants. The proportion of the population that is foreign born has been steadily increasing since the 1950s and, with an expanding immigration policy and decreasing domestic births, it will only continue to increase.

The trend of having the first birth at a later age and decreasing fertility rates is a global and recent phenomenon that is linked to urbanization. In an agrarian society, minimal skills are required for production, so every birth is a quick and direct addition to a family’s labor power. To participate in modern production, however, there is a higher skill and education prerequisite. Communication with others and operation of machinery requires basic language and STEM knowledge. This means that the education cost of every child has dramatically increased, which makes more births less financially sound. Furthermore, as women enter into the city, they become more educated and they are exposed to better education and career prospects. Financial independence and higher education exposes women to the rich and abundant ways to achieve self-fulfillment.

To the B.C. government, fertility rates are falling regardless of free contraception or not. The social welfare money saved from fewer UP, however, are real practical benefits. In the coming decades, we will probably see more Canadians with an immediate ancestry that is of foreign origin than families that have been in Canada for multiple generations. By then, Canadian national identity may further challenge the traditional notion that national identity is based on fixed ancestral habitat.

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