Economic inequality is bad for everyone’s health Michael M. Rachlis MD MSc FRCPC LLD University of Toronto Public Health Interest Group May 1, 2012

Outline: There is more economic inequality in Canada Inequality is bad for health – For individuals at the bottom – For societies There have been big tax cuts in the past years We should restore tax fairness by raising taxes on high earners We need to look to other policies to ensure greater economic and social equity

Healthcare Policy, 7(3) 2012: Healthcare Policy, 7(3) 2012: The Undisciplined Economist. A Casualty in the Class War: Canada's Medicare.. RG Evans.

Impact of Health Inequities 4

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The shrinking Canadian public sector Overall Canadian government revenues have fallen by 5.8% of GDP from 2000 to 2010, the equivalent of $94 Billion in lost revenue – Just half of this, 47 Billion, could eliminate all 2012 Canadian government deficits OR fund first dollar universal pharmacare, long term care and home care AND regulated child care for all parents who want it AND free university tuition AND build 15,000 units of affordable housing units AND the new fighter jets 10

Growing Canadian tax inequality In the 1950s, 60s, the top marginal tax rate (including federal and provincial taxes) was 80% After repeated cuts to taxes and elimination of top tax brackets, the top marginal income tax rate is 46.41% in Ontario This top rate kicks in at $132,406 whereas in the 1960s it started at $400,000 about $2.5 million in today’s dollars The bottom 10% of Canadians pay 30.7% of their income as taxes but the top 10% pay 30.5%

Tax us! Canada is worth it. Our plan calls for higher marginal tax rates for the top 10% (>$100K), 1% (>$170K), 0.1% (>$640K), and 0.01% (>$1.85M) These new taxes would raise about $3.5B for the federal government and $1.7B for the province

We need other policies to ensure economic and social equity Formal anti-poverty programs Early child education Minimum wage policies Other “social wages”, e.g. housing, transportation, recreation, etcetera The health care system Balancing the political equation

Other issues and questions Aren’t taxes coercive? Don’t the rich deserve their money “The poor will always be with us” (Mark 14:7) Won’t the rich leave Canada if we increase their taxes? What type of taxes? – Corporate, consumption, wealth, income?

What about doctors? We are privileged in a literal sense – Legislated monopoly on an essential service – Powers to suspend civil rights We are privileged in a figurative sense – Drs. earn about 6-7 times the Canadian average income We see the health consequences of economic inequality We have a powerful voice

Summary: There is more economic inequality in Canada Inequality is bad for health There have been big tax cuts in the past years We should restore tax fairness by raising taxes on high earners We need to look to other policies to ensure greater economic and social equity

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