Page 66 - ESHRE2019

Justifying public funding of ART
There are two possibilities:
- if you define happiness as ‘desire satisfaction’, then people who want a child and get a child are happier (by definition).
- if you define happiness as ‘subjective well-being’, then people with children are unhappier.
It is difficult to ask money from society to fund an activity that is know to be associated with unhappiness and lower life satisfaction.
So if people wrongly believe that a child will make them happy and satisfied, than we should educate them and inform them about this mistake. Just like we now educate them that they should not postpone pregnancy too long if they want to become pregnant naturally.
Public funding
Each government will have to decide whether or not infertility treatment is part of basic / decent healthcare. The extent of the package depends largely on the wealth of the nation.
Including infertility treatment in this package creates an obligation for the state to guarantee that ART treatment is available for everyone regardless of financial means.
Notice: the starting point here is need. As a consequence, the budget for ART will have to grow if more people fulfil the criteria.
The alternative is a fixed budget for ART. The question then is how this money should be distributed among those who need it (Sweden). This is a different question but the result may be the same given the government’s wish to control expenses. Main instruments: limit the number of cycles and limit age of the woman.
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