Canada and the Three Public Policy Taboos: Promoting Health Equity in Difficult Times

Abstract

Political scientist Julia Lynch outlines three aspects of modern capitalist welfare states that determine the extent of health inequalities: redistribution (transfer of income and wealth from rich to poor); social spending (state expenditures on benefits and assistance as well as social infrastructure); and managing the market economy (legislating working conditions, benefits, and employment security). These processes mediate the contradictions inherent in capitalist societies between capital accumulation or profit making and social reproduction or the ongoing functioning of society. Increasingly, these three public policy directions are seen as taboos by governing authorities, that is, practices to be avoided, and this is especially the case in nations identified as liberal welfare states. In this paper, we explore how Canada – and other liberal welfare states – stand in relation to other Organization for Economic Cooperation and Development countries in its willingness to violate these taboos, thereby reducing health inequalities. Reasons for Canada’s profile are presented as are means of overcoming these taboos in the service of promoting health equity.