Of recent interest, Dr. Tarr, MD of Osoyoos BC has taken the initiative with a group of other physicians to ensure that the society that makes up the economy of the Southern Okanagan will have timely access to medical care. This is highly commendable of Dr. Tarr, but it is justified also to ask whether it is merely a band aid that is being applied that may staunch the bleeding, or is it a model that improves public health and reduces excess consumption of healthcare. (This issue is discussed in my submission to the Romanow Commission in 2002 and in numerous prior and subsequent papers and a driving force in the Canadian Swedish IISRE Research Initiative.)
Consider that healthcare systems in and of themselves, do not create good health in society. It is of note that Dr. Tarr and a few of his colleagues are from South Africa where the relationship between government, health care systems and economic wellbeing is particularly exemplified. They no doubt recognize that somatic and mental health, quality of life, and crime rate in a society are closely related to social, economic and environmental factors. Needless to say, societies with a higher incidence of illness are less productive, have lower social satisfaction and quality of life and less political stability than healthier societies.
Good health is the consequence, in the first instance, of investment by the society in research and education that produces businesses that distribute wealth in society by providing better-trained and better-paid employment; a thriving economy has the resources to provide good healthcare, environmental services, and also clean air and water. Witness First Nation in Canada as an example of a sort of state within a state where lack of economic production and employment causes higher incidents of illness, social problems and disparities with Canada. Adequate welfare and healthcare is imperative but not the long-term solution, though my point here I stress is by no means to disparage either societal obligations to the needy or First Nations burdens, which are not, we must remember, of their own making. It is about justice moral and ethical obligation.
Ultimately, we must recognize that sustainable economic production is the sine qua non for a successful democratically governed mixed economic system such as that of Canada, Sweden, the United States, South Africa, or Mexico et al. They all depend on governments that meet this standard and voters that have a basic understanding of what the task is; government’s task can never be the same as that of the private sector. Bay and Wall Street have their own fish to fry.
For those of my readers that have not studied the mechanics of mixed monetary system such as Canada’s or South Africa’s , I will remind them that such a system requires a thriving private sector, whose task is to pursue profitable investment in economic production that has durability and will sustain lasting employment.
The Government’s task, on the other hand, is to collect taxes and to provide the products and services that the private sector fails to provide, in order to secure the social satisfaction and social stability that society needs.
Hence, one of government’s most important tasks is to technically understand the economy’s allocation mechanism and its faults and to understand what products and services most efficiently can be provided by the private sector or by the government. The government must furthermore present the choices and tradeoffs in an understandable way to apprise voters of the alternatives. Make no mistake: failure in government and voter ignorance will inevitably cause varying degrees of social, economic and ecological adversity. In Okanagan, our society should ask: does development usurp social, economic and ecological realities?
The health care system in the United States is a textbook example of systemic failure in a mixed economy caused by government failure and lack of knowledge among voters. Despite having the highest healthcare consumption in the world, it is most bizarre that millions of Americans lack adequate healthcare.
This imbalance and squandering of resources hampers the United States in its competitiveness in the global marketplace, since in the end it is industry and business, which must carry the healthcare burden, reflecting government failure, and an allocation mechanism that has gone awry. Witness the US trade and current account deficit that must be covered by borrowing from abroad as China. The so-called Obama Care legislation may be seen as solving some of the inadequacies of the system and its misallocation of resources, but the jury is out as to whether it has fixed the problem or simply obscured it in new and as yet unfathomable ways.
Therefore, we turn to access to health care and the GP initiative in the South Okanagan of British Columbia, and the physicians group I mentioned above. Will this initiative increase the understanding of the connection between socioeconomic conditions, education, employment, income and disparities in society and people’s health?
Let it be a reminder that healthcare consumes resources and tax money at the expense of societal investment in the social, economic and environment needs that secure good health in society. We should ask does a health care system consuming plus 40% of the Provincial budget contradict its own purposes by serving another master than the public good?
The experiment with the new physicians’ group could contribute to an increased understanding of the interrelations of economic prosperity and good health and might backwash upon South Africa itself in helpful ways. And so we might ultimately repay South Africa for sending us their doctors.
May 20, 2014
Kell Petersen