The access to fertility treatments in Portugal: patients´ uses and meanings
Department of Sociology University of Minho Portugal,
This paper is about the infertility patients´ accounts of the access to fertility treatments in Portugal. Its main objective is to contribute to the debate around the social, economic and geographic inequalities on the access to these treatments. The empirical research involves 15 semi-structured interviews with patients undergoing fertility treatments in Portugal.
There is no insurance coverage of assisted reproductive technologies in Portugal. In 2007 the Portuguese Government has announced the intention of expanding the access to fertility treatments through a set of economic measures. In order to fulfill this purpose, the Government established partnerships with the private health sector.
The interviewees´ choices between public or private IVF clinics depend on economic, social and organizational elements, namely the following ones: the financial costs involved in the treatment; when the couple expects to start the treatment (some Portuguese public IVF clinics have a long waiting list); the kind of medical care they wish; and their place of residence. The interviewees report practices which they have developed to minimize the inefficiencies of the Portuguese health system concerning the fertility treatments? domain, such as: buying medication in Spain (where the fertility drugs are cheaper); benefiting from a health professional subsystem that finances fertility drugs or treatments; or choosing a clinic with ethical guidelines which are seen as more adequate to their own values.
The political and social mobilization of the interviewees depends mainly on their individual motivations, claiming the access to more health care resources, which should be cheaper, faster and friendlier. However, these motivations are also associated with the interviewees´ views on broader social, cultural, ethical, political and economic problems, for instance the debates about social equality, political priorities and the privatization of the health system.
I conclude that it is important to conceive local and global interventions in order to prevent the marketing of reproductive health. In the case of Portugal, this means to guarantee an equal accessibility to fertility treatments; to resist to the privatization of reproductive health care and to assure its quality and efficacy; and to promote affordable simplified reproductive technologies methods.