Redistributing power, money and resources will improve wellbeing

(Published as “A progressive tax on all forms of wealth would reduce inequality”)

Dr. Trevor Hancock

22 March 2022

700 words

A few weeks ago, before Russia invaded Ukraine and began committing war crimes that have shocked the world (in a way that should have but, to our shame, did not shock the world when Russia did the same thing in Chechnya and Syria), I was writing about inequality and health, in the context of creating a Wellbeing society.

So even though innocent people are still being butchered by Putin and his terrorist army, I will return to this topic because the problem remains and must be addressed, both in Canada and globally.

To refresh your memory, the World Health Organization (WHO) is championing the creation of what it calls Wellbeing societies, in which equitable health is achieved within the ecological limits of the Earth. ‘Equitable health’ is not the same as equal health, but is about ensuring we all have a fair opportunity to be healthy, minimizing inequality as much as possible.

Inequality has health consequences: As the WHO Commission on the Social Determinants of Health memorably put it in 2008: “Social injustice is killing people on a grand scale”.  Thus high levels of inequality are incompatible with a Wellbeing society.

But inequality does not just happen. Instead, as the World Inequality Report 2022 (WIR) noted: “Inequality is a political choice, not an inevitability.”  That political choice is not only killing people on a grand scale, it is creating much social strain and mental and physical ill health through poverty, marginalisation, social exclusion and alienation, resulting in what Nobel Prize-winning economist Sir Angus Deaton calls the ‘diseases of despair’. 

The WIR notes “the period from 1945 or 1950 till 1980 was a period of shrinking inequality in many parts of the world”.  But at the same time, and perhaps contrary to our usual modern expectations, these were also times “of fast productivity growth and increasing prosperity, never matched since” for the countries of the West.

The report goes on to note: “The reason why that was possible had a lot to do with policy—tax rates were high, and there was an ideology that inequality needed to be kept in check, that was shared between the corporate sector, civil society and the government.”

That all changed with the advent of neoliberalism as the dominant ideology, first implemented by Margaret Thatcher in the UK and Ronald Reagan in the USA. As a consequence, the report notes, “contemporary global inequalities are close to early 20th century levels, at the peak of Western imperialism”. The result, says Deaton, a self-professed believer in social democratic capitalism who is now chairing a review of rising inequalities in the UK, is that “I think that today’s inequalities are signs that democratic capitalism is under threat”

To address this, as the 2008 WHO Commission put it in one of its three key recommendations, we have to “tackle the inequitable distribution of power, money, and resources”. Thirteen years later, the WIR made much the same point: “addressing the challenges of the 21st century is not feasible without significant redistribution of income and wealth inequalities.”

 So how should that be done?  The World Inequality Lab, source of the WIR, has what is really a very simple proposition: “a modest progressive wealth tax on global multimillionaires.” They point out that wealth – or at least, one form of it, namely property – is already taxed pretty much all over the world. But they point out it is a flat tax, not progressive – the very rich pay the same rate on their property as the average citizen. Moreover, much of the wealth of the very wealthy is in stocks and bonds and other forms of wealth, not property.

So their recommendation is to expand the property tax to encompass all forms of wealth, not just real estate, and to make it progressive. Such a tax, they find, ranging progressively from 0.6 percent to 3.2 percent of total wealth, would generate $1.74 trillion each year, or 1.6 percent of total global incomes, that could then be “reinvested in education, health and the ecological transition”.

As they note, “it would be completely unreasonable not to ask more of top wealth-holders in the future, especially in light of the social, developmental and environmental challenges ahead.”

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy


Freedom for the sharks, not the minnows

(Published as “Freedom from regulation helps sharks at the expense of minnows”)

Dr. Trevor Hancock

15 March 2022

696 words

Last week I wrote about ‘healthy’ and ‘unhealthy’ freedoms in the context of the Ukrainian fight for freedom from tyranny, compared to the so-called ‘freedom convoy’ that is seeking, Putin-style, to impose their idea of freedom upon us. But there is a level of ‘unhealthy freedom’ that is far worse, in terms of direct health impacts, than that exhibited by these ‘freedom convoys’; the freedom of people and corporations to make money by harming others.

The most obvious example is the tobacco industry, which has until recently been left free to make money for its investors by selling an addictive product that, when used as intended, kills and sickens people in large numbers. But we have seen similar stories in many other industries, most notably in the recent epidemic of drug overdoses, due in large part to the massive marketing of opioids.

Then there are the alcohol, fast food and other industries that have large adverse health impacts; the fossil fuel industry that keeps trying to expand and still tries to confuse the public on the science of climate change – a technique they took directly from the tobacco industry; the pesticide and other chemical companies whose products harm the ecosystem as well as human health, and a whole host of other industries and products that quite legally do harm.

The freedom to harm others for profit is the sort of freedom espoused by libertarians and neoliberals. These freedoms, which Guardian columnist George Monbiot, in an April 2016 column, called the freedom of the pike (I would say ‘sharks’), often come at the expense of what he calls the minnows.

He wrote: “Freedom from trade unions and collective bargaining means the freedom to suppress wages. Freedom from regulation means the freedom to poison rivers, endanger workers, charge iniquitous rates of interest and design exotic financial instruments. Freedom from tax means freedom from the distribution of wealth that lifts people out of poverty.”

These ‘freedoms’ have another consequence; we have become obsessed with the need to get stuff cheap – at any price. As Monbiot notes, it leads to driving down wages and benefits to reduce costs and increase profits. Bizarrely, the ‘right to work’ movement beloved of American Republicans and their supporters involves weakening the power of unions to protect the rights, wages and working conditions of workers, attracting investors to their state to employ people in low wage, low benefit jobs.

The minnows are seduced into supporting such laws, which create jobs but make them worse off while feeding the sharks. But it also strengthens their need to get stuff cheap, because their wages are low, making this a self-reinforcing and self-fulfilling process.

Another consequence of the need to get stuff cheap is shipping jobs off-shore to low-wage economies to reduce costs; the result is not just low wages, but no wages. But it’s not only jobs that get shifted offshore, so too are toxic production processes and dangerous work. Following the logic of neo-liberalism, they go to places where regulations are less stringent and less enforced, thus avoiding the expense of safer production, to the detriment of the health of the local population and the environment.

The neo-liberal sharks, it seems, have been successful in pulling off a neat trick. In the name of populism, they have established a powerful political movement that encourages the minnows to support policies diametrically opposed to their own interests. This is what happens when money becomes the prime value in society. We facilitate and support the system because we save or make money from it – and we don’t really care where it comes from or who gets hurt in the process, as long as it’s not us.

But as Monbiot warned: “Perhaps the most dangerous impact of neoliberalism is not the economic crises it has caused, but the political crisis. As the domain of the state is reduced, our ability to change the course of our lives through voting also contracts.” Neoliberalism erodes democracy, and it erodes the power of the state to aid the weak and vulnerable, to support their freedom to achieve a good life, to thrive. It is the freedom of the sharks, not the minnows.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy

Freedom: The real deal v infantile foot stomping

8 March 2022

Dr. Trevor Hancock

700 words

For the past two Sundays I have joined thousands of others in rallies to stand with Ukraine, support the Ukrainian people and condemn the war criminal in the Kremlin. And on both occasions, we have also seen members of the ‘freedom convoys’, the people protesting vaccines, masks and other mandates. (I won’t call them truckers, that would blacken the name of the vast majority of truckers who have paid attention to the science, understand their social responsibility and have been respectful of the law.)

So I have been musing on these very different aspects of ‘freedom’. On the one hand, the freedom of the Ukrainian people from war, invasion and true tyranny; on the other, freedom from “being asked to wear a piece of paper over their nose and mouth to protect others”, as Dee Snider, former frontman of the heavy metal band Twisted Sister, recently put it. In the 1980s he wrote a song, We’re Not Gonna Take It, that has recently become a resistance anthem for the Ukrainians. But it has also been used by anti-maskers: Mr. Snider approved of the former using his song, but not the latter.

When asked why, he tweeted: “Well, one use is for a righteous battle against oppression; the other is infantile feet stomping against an inconvenience.” In a recent interview on CBC Radio’s ‘As it Happens’ he elaborated further: “One group are fighting for their lives against oppression and tyranny for real. It’s a life and death situation”. The other group, as I already noted, are upset about wearing masks: “It’s just so ludicrous”, he added.

From a public health perspective, I find it useful to distinguish between what might be called healthy and unhealthy freedom. Healthy freedom enables people to fulfil their potential, to flourish. It includes freedom from hunger, fear and, of course, war. But it is rooted in a sense of community. It recognises that one has an obligation to protect the freedom, lives, health and safety of others – and not just others in one’s own family and community, but in humanity is a whole.

Thus it is a constrained freedom, linking freedom with duty, responsibility and obligation. Healthy freedom is not absolute; you do not have the right to harm me, and as a society we have a duty to protect people from the harmful activities of others. You can’t drive on the left because you feel like it, you can’t drive while drunk or ignore stop signs and red lights. Your freedom to smoke, we used to argue, stops at my nose. Or more relevant today, your freedom to make noise stops at my ear.

Unhealthy freedom is when people feel they are free to act in ways that harm others. At its simplest, you are not free to kill others, it is against all moral codes and laws – although there are clearly exceptions even to that; legitimate defensive war, self-defence and where it still exists, legally sanctioned executions. And you don’t have the right to endanger others by ignoring mandates for mask-wearing, vaccine passports or immunisation.

Society, in the shape of public health officials and governments, have put these restrictions in place because, based on what is known, they are likely to protect the majority of the population, including especially the more vulnerable members of society. Where possible, there have to be reasonable accommodations, and nobody wants to restrict freedom any more or for any longer than is deemed necessary. However, freedom is not absolute, there are reasonable limits in a democratic society.

These two sorts of freedom are about to be vividly contrasted in Victoria, it seems. According to a March 7th CHEK News story, a ‘freedom convoy’ is on its way to Victoria from Thunder Bay. The story quotes James Bauder, one of the organizers of the Ottawa occupation, stating “We’re coming to defend your lawful freedom of choice”, adding “We’re going to be occupying that area for two to three months” because the NDP and Liberals have “had their way for too long.”

Sounds disturbingly familiar? This is the same arrogant and shameful rationale behind Putin’s criminal invasion of Ukraine. We can do without that sort of ‘freedom’ being imposed on us!

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

No health without peace

Published as “Here’s how you can help Ukraine — and the world”

1 March 2022

Dr. Trevor Hancock

701 words

I write my weekly columns a week or so before they are published, and submit them five days ahead. So when I wrote my column last week, while there was always the possibility of Russia invading Ukraine, there was still some hope that the Madman of Moscow would not actually do so.  But as I write this the invasion is in full swing, and who knows what the situation will be when it is published – but it does not look good.

I cannot possibly write a column right now about anything else to do with the health of the population, when we are faced with one of the gravest threats to peace I have seen in my 73 years.  A threat to peace is not only a threat to health but to life itself, whether locally or, in the event of nuclear war, globally. Which is why peace is listed first in a short list of prerequisites for health in the 1986 Ottawa Charter for Health Promotion, which is the key founding document for the work that has been the focus of my career.

What is happening in Ukraine is horrifying, as is all war. Indeed, we should not forget that there are equally horrifying international wars underway in Yemen and Ethiopia and numerous other smaller or internal wars around the world. But what makes the Ukraine war so troubling is that Vladimir Putin has compounded his war crimes by fairly explicitly threatening the use of nuclear weapons.

I was 14 at the time of the 1962 Cuban missile crisis and recall the real fear we all had that nuclear war would be unleashed. While we avoided it then, the fear was omni-present, and was crystallised by a 1966 mock-documentary called The War Game, which I saw in my final year of high school. It graphically depicted the run-up to and aftermath of a nuclear attack on Britain and it made me a supporter of nuclear disarmament.

Fifteen or so years later, as a public health physician working for the City of Toronto’s Department of Public Health, I helped the Department undertake a health impact assessment of a one megaton nuclear airburst above Toronto, as part of an international project coordinated by International Physicians for Prevention of Nuclear War (IPPNW). The findings were horrific, as one would expect, and were of course the same around the world. The public awareness that resulted helped move the USA and Russia towards some degree of nuclear disarmament, and won the IPPNW the Nobel Peace Prize in 1985.

These large global geopolitical issues, this violence on the other side of the world, can leave us feeling over-whelmed and helpless, fearful and anxious – although it is of little import compared to the enormity of the fear and stress Putin has imposed on the people of Ukraine, of course, nor the stress experienced by their families and friends around the world.

So on the basis that the antidote to our fear and anxiety – and our outrage – is action, what can we do at a personal level to help the people of Ukraine, and in the process help ourselves? Here are some ideas. Attend rallies in support of Ukraine. Boycott all Russian goods until Russia withdraws – and beyond that. Donate to recognised disaster relief charities  – check with the Ukrainian Congress Canadian or donate through Canada Helps, which manages donations for thousands of legitimate charities –  

Write, phone or e-mail your MP and the Prime Minister  insisting the government support Ukraine in every way possible, including by supplying lethal armaments, and that it seek to brand Putin a war criminal and hold him accountable.

If you have friends or contacts in Ukraine, ask them what you can do. And if you have friends or contacts in Russia, help them understand what Putin is doing and how the world is reacting, because he is keeping them in the dark. If you are a member of an organisation of any sort with international links, see if there are ways to work through that organisation to support Ukraine and to reach out to and inform ordinary Russians about what is happening.

Because there is no health without peace.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy

Increased inequality was a political choice we must reverse

22 February 2022

Dr. Trevor Hancock

701 words

Given the well-documented relationship between high levels of inequality and poor health and social outcomes in high-income countries, which I discussed last week, high levels of inequality cannot be tolerated. But as I also noted last week, the World Inequality Report 2022 states simply: “Inequality is a political choice, not an inevitability.”

The Report’s authors tell us that in the countries of the West, the period between the end of the Second World War and about 1980 was one of “fast productivity growth and increasing prosperity”, and at the same time “a period of shrinking inequality in many parts of the world”. What kept inequality in check, the Report notes, was policies that ensured minimum wages, promoted unions, kept taxes on the wealthy high and regulated business and the economy.

But “income and wealth inequalities have been on the rise nearly everywhere since the 1980s, following a series of deregulation and liberalization programs which took different forms in different countries.” This, of course, was the neoliberal revolution spearheaded by Margaret Thatcher in the UK and Ronald Reagan in the USA, which rolled back the policies that had contributed to low levels of inequality

As a result, we now find inequality rising to levels not seen since the early 20th century. Around 1900, globally, the ratio of the income of the top 10 percent and the bottom 50 percent was more than 16 to 1, but by 1980 this had fallen to 8.5 to 1; today it is back up to 15 to 1, notes the Report.

Things were considerably better here in Canada: In 1900 the ratio was a bit more than 3 to 1, dropping to 1.5 to 1 by 1980. But nonetheless, the Report notes, “income inequality in Canada has been rising significantly over the past 40 years”, and now sits at about 2.5 to 1, due to a combination of “financialization, deregulation and lower taxes.” (Financialization, states Investopedia, is “the increase in size and importance of a country’s financial sector relative to its overall economy”, adding that it “has played a major role in the decline of manufacturing in the U.S.”)

In a 2016 article critiquing neoliberalism, George Monbiot – an eloquent social critic and a columnist for The Guardian in the UK – notes that the neoliberal era has been characterised by a transfer of wealth from the poor to the rich. This is accomplished through “the smashing of trade unions, tax reductions, rising rents, privatisation and deregulation.”

A political ideology that favours privatisation, he notes, results in the rich acquiring public sector resources “such as energy, water, trains, health, education, roads and prisons”, and then charging ‘rent’ (a form of unearned income) for their use, either by private individuals or by the state. Similarly, he writes, the wealthy “acquire increasing control over another crucial asset: money”; they can then charge interest for loans, another form of rent that transfers wealth from the poor to the rich.

Another important but less recognised consequence of neoliberalism is pointed out in the World Inequality Report: “Nations have become richer, but governments have become poor.” In fact, the Report points out, “The share of wealth held by public actors is close to zero or negative in rich countries.” This amounts to a transfer of wealth from the public to the private sector, with serious consequences: “The currently low wealth of governments has important implications for state capacities to tackle inequality in the future, as well as the key challenges of the 21st century such as climate change.”

The creation of rising levels of inequality was a clear political program, a set of policies explicitly intended to increase private wealth and offload responsibility on to the individual. This must be reversed, for the sake of societal wellbeing and future generations.

One obvious way is to re-introduce higher and more progressive levels of income tax; another is to bring in or beef up a wealth tax; a third is to increase corporate taxes. While these may seem radical ideas, in reality they would simply be a return to the way things were in the 1970s, prior to the disaster of the neoliberal revolution. Next week, I will explore some of these proposals for reform.

© Trevor Hancock, 2022

Dr. Trevor Hancock is a retired professor and senior scholar at the

University of Victoria’s School of Public Health and Social Policy