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If Natives can break the health monopoly, more power to them Print E-mail
Written by Link Byfield   
Monday, 26 July 2004

Suppose your child or grandchild contracted some terrible but curable disease, and you were told to line up for treatment--maybe six months, maybe longer.

But suppose also that by remortgaging your home you could buy the service right away in a modern, private hospital with world-class diagnostics.

Oddly, this private hospital happens to be on an Indian reserve outside Calgary. A fair number of Natives work there in various capacities, it's run by first-rate medical staff, and owned by private investors.

Remember, it's your own kid we're talking about.

I know what I would do. And so would any parent who could afford it.

That's what's so intriguing about the recent talk of opening private medical facilities on Indian reserves, where anyone could buy services with their own cash.

Just as they can in every country on earth except (so we're told) Cuba, North Korea and Canada.

Why is it that Canadians (unlike Swedes and other Europeans) can't figure out that state monopolies don't work?

So for everyone's sake, let's hope something comes of this. The medical system needs competition, and Natives need jobs and skills--and not just dealing blackjack in on-reserve casinos.

The idea only comes up because Canada's bizarre healthcare monopoly makes it impossible, almost illegal, for doctors to provide medical treatment for payment by anyone except the provincial governments, subsidized by Ottawa.

Dealing private healthcare in Canada is only slightly more acceptable than dealing crack, and less common.

However, since Indians were granted an undefined "inherent right of self-government" in 1982, it may be they can run their own hospitals on their own land.

Nobody knows if it's legal. Provinces (even Ottawa has conceded this) have sole authority to license medical facilities on reserves. Commerce on reserves, however, is a federal concern, and it is unclear what authority Ottawa still holds to restrict what Natives do.

Ottawa could hardly penalize a province for allowing fee-for-service medicine on reserves if provinces have no legal authority to stop it--except by preventing Indians from having their own hospitals.

Think how THAT would look in the court of world opinion--a world which almost universally (I repeat this because we tend to forget it in five seconds) thinks private medical alternatives are a good thing.

The aboriginal hospital idea surfaced in Saskatchewan, where the Muskeg Lake Band wanted to open an MRI clinic in the chunk of Saskatoon it has carved off for itself as an "urban reserve." Unfortunately, Saskatchewan will not license private medical facilities, for Indians or anyone else.

So the opportunity is now being pow-wowed by serious investors on the many reserves surrounding Lethbridge, Calgary and Edmonton.

They're looking at starting something small like an MRI service, and then ramping it up to a full-fledged private hospital.

Ottawa, caught between renouncing the medicare monopoly or renouncing Indians, will do nothing. It will dither.

The key to success will lie with Ralph Klein. If he ignores the usual howls and hysteria, the Indians will get their jobs, the government medical monopoly will end, and Canadians will join the rest of the world in having options in health care.

Unfortunately, Klein only talks tough now and then, and then loses his nerve.

And so will another Canadian opportunity be squandered.


- Link Byfield

Link Byfield is chairman of the Edmonton-based Citizens Centre for Freedom and Democracy, and an Alberta senator-elect.
"Just Between Us" is a feature service of the Citizens Centre for Freedom and Democracy. The purpose of the Citizens Centre is to enhance freedom and democracy by enabling ordinary citizens to become active and effective on important issues outside the normal processes of party politics.

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