Canada has an outdated expectation that a single, high-quality public health system can be funded out of the general tax revenues.
Dr. Hance Clarke is the director of Pain Services and the medical director of the Pain Research Unit at the Toronto General Hospital. Imran Abdool is a lecturer in Economics and Finance at Western University and member of Western’s Network for Economic and Social Trends research unit.
That idea is in line with most forms of government spending: When most taxes are levied on Canadians, there is no specific expenditures that those tax receipts are restricted to. Second, over the past several decades, major breakthroughs in health care have occurred, including transplantations, vascular prosthetic grafts and cutting-edge gene therapies. But these procedures have come with extremely high costs. The price of medical equipment continues to increase steadily, with PET scanners and MRI machines now costing tens of millions of dollars. Expensive treatments and procedures, once rare, have become mainstream.
Canadians are already among the highest taxed citizens in the world. Considering the variety of ways we are taxed – income tax, capital gains taxes, dividend taxes, property taxes, tariffs, sales taxes, etc – a highly remunerated Canadian could easily see their effective marginal tax rate soar past 50 per cent.
In contrast, some pension plans, notably the defined-contribution types, are fully funded. That would mean that a person’s retirement income is drawn from their own contributions to the plan – assets have already been set aside in a dedicated fund to match what the program needs to pay out . Compared with the former, pay-as-you-go model, the costs of fully funded programs are more manageable and predictable.
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