A treatment worse than the problem

“These are treatments that have become unaffordable for many Americans,” declared White House Staff Secretary Will Scharf. But he wasn’t talking about routine check-ups or common surgical procedures. Instead, Scharf was announcing President Trump’s new executive order on in vitro fertilization (IVF). Realizing his rhetorical slip, he quickly backtracked, “or have been unaffordable for many Americans.” Still, the framing was absurd. IVF has never been meat and potatoes for Middle America--and it isn’t the solution to America’s crisis of low birth rates. Instead, IVF is one more symptom of an elite and alienating technocratic world that comes with an enormous price tag. And its greatest cost of all is the lost human capital.

In any discussion of fertility treatments, Christians are rightly sympathetic with the problem. Infertility is always tragic. Those married couples who wish to conceive children but cannot, feel great pain and loss. They justifiably cry out for answers and often subject themselves to unanswerable and even unfair questions. They deserve our love and compassion. They deserve proper resources for care and appropriate avenues to morally and humanely pursue a family. No discussion of public policy around IVF should ever dismiss their pain.

But as tragic as it is, infertility is not the cause for our national baby bust. Politicizing it in the name of our larger demographic crisis will only make the problem worse.

The White House Fact Sheet suggests making IVF coverage a standard benefit of insurance and one covered by employers, as well as making it a benefit for U.S. military personnel and federal employees. It even presents this as a part of a larger “pro-family” program, but this is a major mistake when viewed on the level of public policy. Apart from people like Elon Musk, most Americans who make use of IVF will not be having a large number of children. The procedure is simply too expensive. The median expense for a successful delivery with IVF is estimated at around $60,000. Complicating factors, which are not uncommon, can cause the cost to easily exceed $100,000. Some cases have exceeded $800,000.

These sorts of numbers are surely why President Trump believes that the United States should offer an insurance mandate for IVF. But these costs will not truly be reduced. They will have to be shared. This is a policy that will make Obamacare look like a bargain.

Spreading out higher insurance and healthcare prices across the national economy will simply make it more difficult for the average American to have the kinds of large families needed to reduce our falling birth rate. You don’t even have to consider luxury items or excessive consumption. The simple budget demands of family necessities will dictate the number of children. For many Americans, that number is already approaching zero.

To truly solve this problem, it’s essential to understand that the reason many Americans are not having children is not because they cannot. It is because they do not want to have children. And this isn’t only because of selfishness or an innate hostility to the concept of parenting. This bias is because the societal features that make for a hospitable and reasonable family lifestyle are vanishing. Affordable homes with suitable outdoor space, extended family networks, an appropriate home and work balance, safe and affordable schools that will impart both knowledge and virtue—these are extremely hard to find for most Americans. Without them, the prospect of having a family, the truly big picture, is too daunting. When the ordinary or “normal” American life is so different from one hospitable to the life and needs of the family, it’s not a surprise that ordinary and “normal” Americans don’t start families.

But widespread IVF use will have an even greater cost: the mass taking of human life. In the average case of in vitro fertilization, two-to-three embryos on average are needed for one successful delivery. The doctors prefer to have even more on hand for the sake of efficiency. Since only one child is usually delivered, this means that most cases of IVF involve the termination of multiple human lives. These fertilized eggs are living human beings, simply in a very small state. According to orthodox Christian moral teaching, these human beings are already human persons. And many of them are held as remainders for the procedure and then eventually discarded as unnecessary extras.

This is the hidden human cost of IVF. Add to this the not uncommon practice of freezing embryos or of individual males using IVF to have children with multiple women and the larger picture quickly becomes dystopian. The clinical veil conceals a great evil, the mass devaluing of human life.

Even if we were able to guarantee that no fertilized eggs were destroyed (which is impossible for any viable national policy), we are still left to ask whether IVF is a humane and hospitable way to treat human persons at all. The steps needed to make the procedure possible in the first place are usually glossed over, but they raise their own moral questions. Just how are these human materials being supplied? What does it take to get there? When we then consider the implications of injecting medical intermediaries into the process of human conception itself, it’s hard to see this as a healthy, humane, and hospitable social program.

Christians should mourn with those who mourn infertility, but we must point to a better way of solving our national crisis. We don’t need to spread out the costs of risky and expensive medical electives. Instead, we need to find ways to generate wealth for more people, create affordable family friendly spaces, and cast a vision of American life that welcomes children. We need to inspire Americans to get and stay married and to raise their children in love.

This will require a much bigger picture than merely expanding our current technocratic society. It will require old concepts like nurture and admonition. It will require us to rediscover what it means to be human, that we are children of our Father in Heaven and all our children are a heritage and gift from Him.