BUYING FERTILITY

Should childless couples have to pay for fertility treatment, or should the state's health service provide it for free?

This is a tough one, since two objects of public policy are pulling in opposite directions. On the one hand, we know that healthcare costs will continue to rise almost exponentially, as we all get older, and the medical profession finds more and more ways to keep us alive. Against that background, health authorities are increasingly refusing to allow patients to receive certain types of treatment for free. Dentistry is a good example. Even in Denmark, where healthcare is tax-funded and generally free, you have to pay part of the cost of dental treatment, unless you are a child and it is a medical necessity. In other countries, dentistry is completely privatised. And where dentistry leads, other treatments may follow; cosmetic surgery, liposuction (fat removal) etc etc. For many people, fertility treatment is more of a lifestyle problem than a health problem, and shouldn't, therefore, be free.

On the other hand, we also know that rich societies are not producing enough babies, who will grow up and generate the tax revenues needed to pay for all those healthcare costs (and other things). It is estimated that roughly 8% of all babies in Denmark are born after some sort of fertility assistance. But if health authorities charge for fertility treatment, then fewer couples will seek it, so fewer babies will be born than would otherwise be the case. Leading to fewer revenues for the state in 20-50 years' time.

What to do? In essence, this is an investment decision. And like any other investment decision, the costs (in terms of free treatment) are up-front and certain, while the benefits (in terms of tax revenues) are in the future and uncertain. Given today's economic situation, it is perhaps not so surprising that the cost arguments have won out. The Danish Government started charging for fertility treatment from 1 January this year, at kr.15.000 (roughly £1,750) a throw. It is already clear, after a couple of months, that demand has fallen, and at a rate which will lead to perhaps 500 fewer babies being born this year than otherwise. The current Finance Minister may well view this as a good idea; I am not sure the Finance Minister in 2040 will.

Walter Blotscher