Equity in Times of Austerity: Ontario’s Revenue Crisis in Historical Perspective
Keywords:
health equity, austerityAbstract
Concerns for health equity have found entry into social policy discussions in Canada at both the national and provincial levels of government. However, in the aftermath of the global financial crisis social programs improving the distribution of social determinants of health (SDHs), such as adequate housing and income, secure employment opportunities, affordable education and health care are increasingly under attack. In light of persistent deficits, historically high debt, and the precarious state of the global economy, there is a need to re-examine various revenue tools as, to date, there has been little historical analysis of the structural changes made to revenue sources or acknowledgment of the need to re-examine the revenue side of government activity in addressing fiscal imbalances. The article interrogates changes to the Ontario taxation system, especially during the deepening of neoliberal policies in the province (post 1990), to provide historical context to the current state of the provincial treasury. It focuses particularly on income, sales, and corporate income tax, which comprise the majority of revenue generated through taxation. The decline in government revenue is then linked to three key pathways affecting the distribution of social determinants of health: social assistance, labour market policy, and housing. The article finally probes the plausibility of alternative tax structure scenarios and their potential for financing social programs that address health equity.
Résumé
Une préoccupation pour l’équité en matière de santé a été incorporée aux discussions de politiques sociales, tant au niveau provinciale que fédérale. Cependant, suivant la crise financière globale, l’amélioration d’une distribution plus équitable des déterminants sociaux de la santé par des programmes d’aide sociale, comme un logement et un revenu approprié, la sécurité d’emploi, une éducation et des soins de santé accessibles, sont chaque jours plus menacés. Considérant les déficits constants, un historique de dette élevée, ainsi que l’état précaire de l’économie globale, il existe un réel besoin de réexaminer différents outils du revenu. À date, il n’y a eu que très peu d’analyses historiques des changements structuraux qui ont été apportés aux sources de revenus, et même, de la nécessité de réexaminer le côté revenu de l’activité gouvernementale lorsqu’ on aborde le déséquilibre budgétaire. Cet article interroge les changements apportés au système de taxation de l’Ontario, surtout lors de l’approfondissement des politiques néolibérales (après 1990), afin d’offrir une analyse historique de l’état actuel de la trésorerie provinciale. L’article examine plus particulièrement les taxes sur le revenu, les ventes, et sur la fiscalité des sociétés, ce qui comprend la vaste majorité des revenus obtenus à travers la taxation. La baisse de revenus gouvernementaux est reliée avec trois voies majeures affectant la distribution des déterminants sociaux de la santé: l’assistance sociale, la politique du marché du travail, et le logement. Finalement, des structures de taxes alternatives sont examinées, ainsi que leur plausibilité et leur potentiel pour financer des programmes d’assistance sociale qui traitera de l’équité en matière de santé.
Mots-clefs: équité en matière de santé; austérité
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