[Extract] Idealized versions of health care are common, and access to health care is often viewed as an unambiguous good. In the social determinants of health literature, for example, access to health care is treated as an intermediate determinant of health. This conceals a simplistic inference: the better your access to health care, the better your health. The reality is more complex: a modern industrial health care system can be a determinant of ill health, especially where it is culturally unsafe. At present, Canadian health care for Indigenous people is not culturally safe owing to the ways that health law, health policy and health practice continue to erode Indigenous cultural identities.