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Society should be very concerned about the intention of Westbank First Nation to open a private commercial hospital.  The implications of such a move could be dramatic and should spur vigorous public discussion. 

My entry into the discussion should not be taken as criticism of Westbank First Nation.    

As a virtually private economic entity under federal legislation, the Band is legally entitled to invest in viable economic projects in the pursuit of profit.  I merely (and humbly) wish to suggest that this particular economic project has broader, and possibly bad, implications for society at large.  

Is it the proper role for a private entity in Canada to pursue profit in the health care arena, given that Canada has already chosen to provide universal health provided by government?  In mixed economy, such as Canada’s, certain functions are reserved to the private sector; other functions or needs of society are within the purview of the government.   Health care is among those basic needs of society that the Canadian government provides to one and all, in order to reduce disparities in society and provide an essential public service.  The private sector, on the other hand, by its very nature will provide health care only if it is profitable economically to a particular private entity.  

Lest we grow complacent about where the dividing lines might be between public and private sector responsibility, we need only look to the South, where the United States private system fails roughly 45 million Americans, who lack access to adequate healthcare.  Unless you have a job and can receive employer sponsored health care, you are pretty much on your own.  The US healthcare model creates disparities and is a serious hindrance to the economic wellbeing of Americans as a whole.  The recent Affordable Care Act in the United States (dubbed by some “Obamacare”)  is only a patch that attempts to stop the hemorrhaging without curing the problem.  

Canada’s public healthcare system is one of the most important comparative advantages for Canadian industry.  It frees the private sector to play its proper productive role in the global economy, freed of providing a service (health care) that the Canadian government has taken under its wing.  Canadian health care consumes 11.4% of GDP and costs $4,444.00 per capita and it provides everyone with reasonable access to health care.  The US private system, on the other hand, consumes some 17.7% of GDP and $8,232.00 per capita and fails to provide universal coverage.   

Do we want to head back in the direction of the troubled, flawed, and expensive US system?  Westbank First Nation, as well as the Canadian public at large should take note.  Are we, by stealth, and out of shortsighted political motivation, going to dismantle the Canadian healthcare system?  Outsourcing and privatization are in fashion right now,  but they ignore generations of economic research and warnings as to their likely outcomes,  and they present great dangers for mixed economic models we have constructed in the Western world.   

Compare the Canadian healthcare model with Cuba’s are not relevant. More than 95% of Canadian physicians are tax-sheltering, incorporated, capitalists, whose bulk income comes from the State thus the taxpayer and therein lies some of the problem.  Keep in mind it doesn’t matter whether resources is allocated of private sector  for profit or of the government resources can only be used in one direction on the expense of other aims in society.  Hence the reality is excess consumption of healthcare are on the expense of the socioeconomic and ecological factors that reduce disparities and create good somatic and mental health in society.  Such as investment in relevant research, education, in business and employment hence healthcare can reach a point where it simply contradicts it own purpose.  Realities few inside our healthcare system want to discuss, our politicians should but the voters are absent so they don’t? 

 Ultimately, make no mistake: in mixed economies such as Canada’s and that of the United States,  when the government fails to perform its proper role, in contrast to the role of the private sector – think Bay and Wall Street --  the economy as a whole fails.   

We are presented with the additional problem, also implicating democratic failure, in the present context, with respect to the responsibility of a First Nation government toward the Canadian government and toward the Canadian people as a whole.   Presumably, if they are thinking about the implications,  West bank First Nation may feel no allegiance to the Canadian public health care system and may be opening yet another breach in the social compact between the interests of Native people and the rest of Canadian society. 

 Kelowna September 23, 2013

 Kell Petersen


Kell Petersen