Two columns the same day in the Globe on birth tourism. Always nice to see some of my analysis provoking more public discussion:

Starting with the stronger piece by health reporter, André Picard:

Birth tourism is the name given to the practice of pregnant women travelling to Canada from other countries – predominantly China – to give birth. They do so because children born on Canadian soil automatically become Canadian citizens.

The children, known as passport babies, can eventually benefit from lower university tuition, visa-free travel to many countries, and even sponsor other family members to become citizens. For wealthy Chinese nationals, it’s a golden ticket out of a country with a repressive regime.

But the practice raises the question: Should Canadians hospitals – unwittingly or not – be selling citizenship?

Until recently, birth tourism was viewed as a marginal issue. Statistics Canada reported that, out of 383,315 births in 2016, only 313 babies were born to mothers who don’t live in Canada. But anecdotal reports suggested the real number of passport babies was much higher.

Andrew Griffith, a fellow at the Canadian Global Affairs Institute, did a deep dive into data from the Canadian Institute for Health Information and foundthere were 3,223 births by non-residents in Canadian hospitals in 2016, excluding Quebec.

That number has since jumped to 4,099 in 2018.

Some of those births could be international students or temporary residents working in Canada, but there is no question the large majority travelled with the express purpose of giving birth in this country.

In B.C., Richmond Hospital alone had 453 births by non-resident mothers last year, 23 per cent of all births. Mackenzie Health in Richmond Hill, Ont., had 229 birth tourists, 13.3 per cent of its births.

Birth tourism is not cheap – roughly $60,000, including hospital fees and a three-month stay in a “birth house,” facilities that have sprung up, mostly around hospitals in suburban Vancouver and Toronto.

There are more than two dozen birth houses in Richmond, B.C. alone. Brokers in China widely advertise the benefits of giving birth in the “maple syrup kingdom,” and collect hefty commissions.

Kathleen Ross, president of Doctors of B.C., recently spoke out about the practice, saying it is straining hospital resources and putting doctors in an impossible position.

While it would be unethical for a doctor to not assist a woman giving birth, some, such as Dr. Ross, have been stiffed by clients who didn’t pay. (An obstetrician is paid between $600 and $1,500 for a birth but they must collect privately if a patient is not covered by medicare.)

Hospitals also had problems collecting from birth tourists. The South China Morning Post reported on the case of the “million-dollar baby,” a patient who had a complicated birth and racked up costs totalling $312,595, then skipped town. Last year, Vancouver Coastal Health Authority sued Yai Xia, alleging she now owes $1.2-million with interest dating back to 2012.

Most hospitals now demand upfront payments, ranging from $8,000 to $15,000. Whether the parents pay or not, the passport babies still have Canadian citizenship. Canada is only one of about three dozen countries in the world which grants birthright citizenship – automatic citizenship to anyone born on Canadian soil. This has been the practice since 1947.

The government of Stephen Harper considered changing the law but determined it would result in too many unintended consequences. Canadians generally use birth certificates to access government services; if citizenship was in question, they would require passports, and 40 per cent of Canadians don’t have a passport.

Birth tourism rankles the public because it feels like cheating. Both Liberal MP Joe Peschisolido and Conservative MP Alice Wong have tabled petitions in the Commons demanding change. It’s not a coincidence that they both represent ridings with large immigrant populations. Newcomers appreciate the difficulty obtaining and the privilege of citizenship.

The answer is not to toss out the jus soli (right of the soil) principle that is part of Canada’s heritage, but to address the specific challenge posed by birth tourism.

The way to do that is to adopt visa restrictions – denying visas to women who are coming to Canada expressly to give birth, and to crack down on both brokers and birth houses. We could also go the way of Australia, which modified its laws so that citizenship was granted only if one of the parents was a citizen or permanent resident, or the child lives at least 10 years in the country.

Neither Canadian identity nor the Canadian health system is threatened by birth tourism. The central issue is fair play: Canada should remain a welcoming country but not one whose citizenship is for sale.

Source: Opinion: Canada shouldn’t welcome birth tourists

Political columnist Konrad Yakabuski:

No one was surprised to learn that Donald Trump was wrong when he declared that the United States is “the only country in the world” that grants birthright citizenship. The U.S. President rarely lets the facts get in the way of an opportunity to score political points on the backs of immigrants.

Unsurprisingly, he was also wrong in suggesting he could revoke U.S. birthright citizenship, which is entrenched in the U.S. Constitution, with the simple stroke of his own pen. But on the eve of midterm elections that will determine control of the U.S. Congress, stoking outrage toward illegal immigrants who give birth on American soil is par for the course for Mr. Trump.

Unfortunately for Canada’s Conservatives, who adopted a resolution at their August convention calling for an end to “birth tourism” in this country, Mr. Trump’s outburst now risks tainting our own debate about birthright citizenship. Even before the U.S. President evoked ending birthright citizenship in his country, opponents seized on the passage of the Tory resolution to score points of their own. New Democratic Leader Jagmeet Singh attacked the “division and hate” peddled by Conservatives. Prime Minister Justin Trudeau’s principal secretary, Gerald Butts, accused the Tories of seeking to “strip people born in Canada” of their Canadian passports.

To be clear, any attempt by the Conservatives to scapegoat certain immigrants for political gain should be condemned. But so should Liberal and NDP attempts to tar the Tories with labels they don’t deserve merely for raising concerns about a phenomenon that undermines the integrity of our immigration laws. Birth tourism, the practice of foreign women coming to Canada to have their babies merely to obtain a Canadian passport for their offspring, is by all accounts a real and growing problem. Is it a big enough problem to warrant an end to birthright citizenship here? Unfortunately, we don’t have good enough data to know. Statistics Canada data on births to non-resident mothers provide an incomplete picture and conflict with evidence reported by hospitals.

In the United States, birthright citizenship emerged as a constitutional principle in the wake of the U.S. Civil War to ensure that freed slaves were entitled to all the rights and privileges of white citizens. It is rooted, hence, in that country’s long struggle against slavery and racial discrimination. Any attempt to deprive those born on American soil of U.S. citizenship would not only require a near-impossible constitutional amendment, it would needlessly reopen old wounds.

In Canada, the issue is not nearly as fraught with symbolism as it is south of the border. Birthright citizenship is a feature of our immigration law, not the Constitution, and can be changed with an act of Parliament. What’s more, federal lawyers recently argued that Canadian citizenship could not be claimed by the Canadian-born children of Russian spies, insisting that even this Liberal government believes the principle of birthright citizenship has its limits.

In most cases, foreigners who travel to Canada to give birth are not desperate, nor are their children at risk of becoming stateless, since they would inherit their parents’ citizenship, anyway. Most appear willing to pay hefty non-resident medical fees to have their babies delivered at Canadian hospitals or stay at for-profit “birth houses” catering to Chinese tourists.

Canada would not be the first country to end birthright citizenship, in part to end the practice of birth tourism. Several developed countries, including Australia, have done so in recent decades. As Canada becomes one of the last “rich” countries outside of the United States to grant automatic citizenship to those born on its soil, we should expect the incidence of birth tourism to increase in the future. That suggests we need to be prepared to have this debate, sooner or later.

The August Conservative resolution called for legislation to eliminate birthright citizenship “unless one of the parents of the child born in Canada is a Canadian citizen or permanent resident of Canada.” Leader Andrew Scheer insisted the policy was aimed strictly at ending “abuse” of our immigration laws, adding: “Conservatives recognize that there are many Canadians who have been born in Canada by parents who have come here to stay and have contributed greatly to our country. I will not end the core policy that facilitates this.”

It would be premature to change our immigration laws before we evaluate alternatives, such as stricter visa requirements, to prevent birth tourism. Ottawa also needs to collect better data to determine the scope of the problem. But we should not let the spectre of Mr. Trump stop us from having a debate about our immigration laws that, if we wait too long, could become inevitable.