Society should appreciate physicians such as Dr. David Cleveland of Penticton!

Society should appreciate physicians such as Dr. David Cleveland of Penticton, for recently speaking out about lifestyle and behavioural factors causing excess consumption of healthcare.  Dr. Cleveland’s concern indicates his approach to medicine is public health, and while clinical health is vital to society some of the time, public health is vital to society all the time. Dr. Cleveland seems concerned with the health of the community as whole. The problem for the present and future generations is that resources and investment cannot be used in one direction without being at the expense of other aims in society – the opportunity cost.  Obviously, excess consumption of clinical healthcare and treating preventive diseases takes up resources that cannot be used for investment in factors that creates good health and prevents diseases.  It often seems forgotten that it is not healthcare nor the healthcare system that creates good somatic and mental health in the society that makes up an economy.  Lasting social satisfaction, good health, political stability and a sound environment, is created by investment in research, education and training that produces sustainable economic production.  That means investment in viable businesses that distribute wealth in local and regional economies via better paid employment – rather than welfare.  After all, in the end, healthcare spending must be carried by industry and business. Hence, excess consumption of healthcare is at the expense of the factors that created good health, and that contradicts it own purpose.  Excess consumption of healthcare makes Canada less competitive in the global marketplace and a less attractive economy to invest in.  Besides research, education and training, a well managed public health care system is the most important comparative advantage any economy can have. In perspective, the approximate average per capita spending on healthcare in the OECD countries is US$2,800.  In Canada $3,300, which can be compared with an amazing $6,600 per capita or double in the USA’s mainly private healthcare system.  Even with this USA spending, 47 million plus Americans have no access to adequate healthcare.  The high consumption of healthcare and insurance cost; somewhere between $10,000 and $13,000 per family, is a damaging burden for the US economy.  The most effective way to erode BC and Canada’s comparable advantages in the global economy and hamper investment is to allow the public healthcare system to fail.  This is the issue colleagues and I addressed in a discussion paper to the then BC government in 1994 and in a subsequent paper and meetings, also with the CEO and the Chair for Interior Health.  There is much to say, but in short, as Franz Kafka put it “the message was given, nothing changed”.   In my research and in my practice, I am concerned with unlimited human aspiration, versus limited resources that have alternative uses, because I am concerned for the community and humanity. It is encouraging to see physicians as Dr. David Cleveland that seem to share similar concerns.  This reflects moral and ethical values. Recently, from attending a lunch with the Premier and Cabinet, it was encouraging to sense that our Premier and government are open to new ideas and approaches.  Such a new approach is the Canadian Swedish IISRE Initiative, research needed to tackle the underlying systemic problems that fuel clinical somatic and mental excess healthcare spending, at the expense of the socioeconomic and ecological factors that created a strong sustainable economy and good health – a global problem.

March 17, 2008

Kell Petersen

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