This document was prepared by Dr J Millar for the consideration of the Policy, Advocacy and Research Committee (PARC) of the Public Health Association of BC –Nov.21, 2015
The purpose of this paper is to provide a focus for discussion leading to the development of a framework for a policy and action agenda for PHABC advocacy in pursuit of improved and more equitable population health and social justice.
Socioeconomic (SE) inequities in Canada are increasing and an unacceptable level of poverty persists. Wealth is increasingly concentrated in the hands of the elite (the 1%). This leads to poorer population health, increased healthcare expenditures, a slower economy, environmental degradation, climate change, the erosion of democracy and the increasing likelihood of social unrest.
When the market mechanism fails there is a need for effective government intervention. The role of government in restoring a market-based economy that leads to more equitably shared prosperity is to provide some level of redistribution of income and wealth through taxes, transfers and stimulus spending. At the same time government can use policy and regulatory levers to ‘nudge’ a cultural change in the business sector that can achieve ‘predistribution’ – more equitable employment income and more responsibility for population health and environmental sustainability.
While the culture in the business community over the past century has been predominantly characterized by a focus on growth, profits and shareholder value, a number of business leaders and organizations are speaking out about the failure of the market economy in its present form. Current practices have resulted in increasing socio-economic inequity, poverty and climate change. The good news is such transformative change is occurring in the business culture. With the leadership of progressive businesses and academic leaders, business culture is evolving so that not only shareholders and executives benefit from a successful enterprise but also employees and the entire value chain (suppliers, distributors, energy and resource use, employee health and safety, environmental impact) share more equitably in wealth and prosperity.
PHABC looks forward to working with progressive elements in our governments and business communities to look beyond the bottom line and make progress toward ‘shared value’ as the basis for ‘regenerative capitalism,.
Tax policies: (potentially federal and provincial governments)
- Increase the top marginal income tax rate
- Tax all income sources fairly and equally including capital gains and dividends
- Introduce wealth and inheritance taxes
- Tax socially harmful products and practices (carbon tax, polluter pays, tobacco, alcohol, sugar, etc.)
- Reform tax incentives and subsidies that incentivize fossil fuel consumption and instead incentivize innovation that is environmentally sustainable and supports the creation of healthy products
Employment policies for all levels of government:
- Living wage for all employees – direct and out-sourced
- Equal pay for equal work
- Employee health – parental, mental health leave provisos, personal development, education
Social and physical infrastructure interventions:
- Increase welfare rates, EI rates, the Working Income Tax Benefit, the Child Tax Benefit and the GIS for seniors
- Universal public affordable quality child care
- Improvements in education primary through post-secondary
- Improvements in health care
- More social housing, end homelessness
- Invest in sustainable energy – including electrical grid improvements, sustainable energy sources
- Better public transit
- Improved communications
- Sewage and water system maintenance
- Environmental protection and restoration
- A national poverty reduction plan (including BC, the only province without a plan)
- Sovereign wealth funds to raise public revenue and sustainably manage natural resources
‘Nudging’ the business sector:
- Reducing exorbitant CEO/executive compensation
- Controlling stock buybacks
- Providing for labour representation on corporate boards
Transformation of the business sector.
The business sector, for the most part, continues to be exclusively focussed on growth, profits and increasing shareholder value. This is a long tradition and unlikely to change quickly. But change is occurring and with the leadership of progressive businesses and academic leaders that look beyond the bottom line, there is some progress in evolving toward ‘shared value’ as the basis for ‘regenerative capitalism’.