On June 30, Ontario Health Minister Christine Elliott announced that minors and young adults who have private medication insurance will no longer be able to have their prescriptions covered by the provincial government program. Under OHIP+, people 24 years of age or younger were able to obtain a range of medication for free, paid by the government, whether or not they were eligible for coverage under a private plan.
The cost-cutting measure appears more than reasonable at first glance. Why should tax dollars pay for private corporations' profits? They make enough money, and those tax dollars are needed elsewhere. Behind this reasonable façade, however, lies a policy change which will set Ontario back in terms of reproductive rights, trans rights and sexual health.
By forcing youth to claim coverage under private insurance before seeking OHIP+ reimbursement, parents are granted powers of surveillance over the medical decisions of their children, even if they are legally capable of making their own medical decisions and endowed with the rights to privacy that come with those decision-making powers.
Private coverage for those under 25 most commonly comes in the form of parental plans. They are listed as dependents on their parents' private insurance. Parents hold the information needed to make a claim — such as contract and certificate numbers — and claim forms done manually tend to require the parents' signature. It is difficult if not impossible to obtain coverage without directly asking parents, and any claim would make its way to the claims history, informing the parents of the medications prescribed.
In other words, those under 25 who are covered under their parental plans will no longer benefit from medical privacy with regards to their prescription drugs.
Abusive parents will be able to use this newfound power of surveillance to maintain control over their children.
Many youth will have no problem telling their parents which medications they are taking. I know I tell my parents even though I am older than 24 years old. Those who will be most impacted by the new policy are those who have a difficult or tense relationship with their parents. In particular, abusive parents will be able to use this newfound power of surveillance to maintain control over their children. Although there are ways to avoid this situation, such as emancipation, it is a difficult process which requires a breakdown of the family relationship, an inaccessible cost for those who rely on parental support to live or who have a strong emotional attachment to their family.
Among those medications most likely to raise difficulties are birth control, hormone replacement therapy for transgender people and treatment for sexually transmitted infections. Trans people will be outed to their parents when they seek medically necessary transition-related care. People who have sexually transmitted infections may delay seeking out medical care out of fear of their parents' reactions. And those who rely on birth control to prevent pregnancy — for the most part women — will see control of their reproductive capacities shifted ever-so-slightly back into the hands of their parents.
Of course, parents are justifiably granted control over their children's medical decisions in many cases. However, this policy shift mines the medical privacy of adults up to 25 years old as well as minors who, by law and on a case-by-case basis, are considered sufficiently mature to make their own medical decisions privately. It is not limited to cases where parents have a right to oversee their children's medical treatments. Impeding on the medical privacy of adults and mature minors is inconsistent with their recognized capacity to determine their medical care and the privacy that comes with it.
This policy signals the erosion of medical privacy for those under 25 years old. We can all think of a time when we, for one legitimate reason or another, wished to withhold personal medical information from parents, be it indefinitely or temporarily. Under the Doug Ford government's new policy, it will no longer be possible for a significant portion of our population. Medical privacy for minors and young adults will be seriously compromised.
To allow this policy change is to send the message that women and trans people of all genders do not matter.
This measure will likely come with a rise in under-the-counter medication. The grey and black pharmaceutical market will see high demand, as it did before 1969, when selling birth control was illegal. Mail-order pharmacies, often relied upon by trans people due to the barriers in accessing transition-related care, will benefit. The Ontarian population will not.
This is a clear step back. My body, my choice. Personal autonomy and bodily integrity are fundamental values of Canadian society and are firmly enshrined in our legal system. Medical decision-making powers cannot rest in the hands of parents of autonomous minors and young adults without committing a grave sin against our moral order. Sound financial policy does not come from eviscerating privacy and autonomy.
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To allow this policy change is to send the message that women and trans people of all genders do not matter. It is to send the message that sexual health is not worth paying for. It is to send the message that we are willing to let our society rollback hard-won rights. We can only hope the government will recognize their mistake in time and rectify their trajectory.
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