Restricting abortion

Remember last November when Federal Health Minister Tony Abbott and his parliamentary secretary, Christopher Pyne, claimed there was an "abortion epidemic" (although the Australian Medical Association disputed this at the time)?

Remember everyone calmed down when it was recalled that abortion was a state legislated matter, out of the Federal Government's control?

Guess what: the benignly-named Health Legislation Amendment Bill 2005, will if passed, restrict Medicare funding for some types of surgery, including abortion.

Australians have until this Wednesday, October 12, to make a submission to the Senate's Community Affairs Committee about the proposed changes, which were only made public at the end of last week.

And even now, there are gaps in what we may know about these changes. We know that the amendments will give the Minister a new power to determine that Medicare rebates will not be applied to medical services in "specified circumstances". But those specified circumstances, to be outlined in a new legislative instrument, are not yet clear.

Of perhaps greater concern is a whole new section to the Health Insurance Act 1973 (4BAA) which “will restrict items of medical, diagnostic imaging and pathology services by making those items subject to conditions, limitations or restrictions”, according to Mr Abbott. But how? The Minister isn't saying. Despite research, Section 4BAA cannot be located for perusal.

Last year, our canny Prime Minister saw the political danger of being anti-abortion and declared, "There will be no government-sponsored change at the federal level to the current legal status of abortion". This has left plenty of "wriggle room" for the Health Minister to address the availability and the affordability of abortions in the proposed legislation.

So what's going on?

Under this proposed legislation, it appears that the Minister for Health will have the power to restrict the procedures to be funded by Medicare, and can make these changes merely by tabling them in Parliament.

Here's what to watch for: the two Medicare item numbers used for abortions are also used for a number of other purposes (which is why the figures on abortion are so unreliable). Item 35643 is used by gynaecologists for both abortion and for blighted ova, missed abortions and molar pregnancies. Item 35640 is used for incomplete miscarriages, where there is significant bleeding and passage of some pregnancy tissue but there are retained products of conception requiring curettage.

Under these new powers, we can only speculate how new arrangements might work. Might your doctor have to explain to the Minister that you need a curette for an incomplete miscarriage rather than a termination?

Will your doctor be able to claim for the use of the diagnostic imaging technology to find out whether or not your baby has a condition that is incompatible with life?

If the Minister can decide the circumstances in which Medicare benefits are payable, what circumstances will he take into account? Rape, for example?

Last November, The Age reported Mr Abbott as saying, "The government had no plans to change existing policy about the public funding of terminations". However the Catholic Church certainly thought it should, and said so at the time. Catholic Health Australia chief executive Francis Sullivan called for the issue to be put on the agenda for the next health ministers' summit. Australian Federation of Right to Life Associations spokeswoman Kath Woolf said Medicare funding for late-term abortions needed to be stopped.

Perhaps what Mr Abbott really meant was what he said to the Catholic Administrators Conference in Sydney last October:

I want to invite representatives of the Church, leaders of the Church, to consider the Church’s role in combating the great tragedy of abortion in Australia today …

"If only as a culture we were as clear cut as even John Kerry, the US presidential candidate who says that abortion should be safe, that’s what he says. Available, that’s what he says, and almost never chosen. And that’s the issue. It should not be chosen …

But Catholic attitudes to abortion over the centuries have not been consistent and unchanging. From St Augustine until the 19th century the dominant Catholic view was that “life” began at 40 days after conception, when the soul entered the body ("animation"). St Augustine (AD 354-430) said, “There cannot yet be said to be a live soul in a body that lacks sensation”. St Thomas Aquinas (1225-1274) also considered only the abortion of an "animated" fetus as murder. The contemporary Catholic position that life begins at conception was adopted only in 1869, when the distinction between “inanimate” and “animate” fetuses was dropped.

In Australia today, there is much proper concern about the rights and wrongs of the termination of a pregnancy. It is desirable that the community debates such an important issue. After doing so, the community will perhaps seek to alter the status quo.

What is not reasonable is the imposition of the Health Minister's ideological point of view on this or any other issue, by “legislative instrument”, without proper public awareness and the necessary debate.

Soon after his last election win, Mr Howard told the ABC that he believed that abortion was in some circumstances "absolutely justified". He also said that he was not "somebody who seeks to impose my own personal views on the rest of the community." But this legislation is a back door route to permit the Minister for Health to impose his views on the community.

Australians have until this Wednesday to let the Senate know just how they feel about that.