Six Pillars of Social Policy: The State of Pensions and Health Care in Canada

William B.P. Robson, a co-author with David Slater of a series of papers on pension issues, has written an ambitious survey of the state of Canadian economic policy in the areas of pensions and health care. He argues that it is appropriate to tackle both issues in the same paper because they are both major spending programs strongly related to the life cycle of Canadians, and face challenges arising from the aging of the population. Robson notes that the pension debate uses the metaphor of three pillars to describe a comprehensive pension system: a safety net to guard against destitution in old age; a mandatory employment-related system to provide basic replacement income; and a voluntary system supported by provisions that reduce the double-taxation of saving. The main elements of public policy related to pensions in Canada cover these pillars. He recognizes that all three of the pillars cannot be directly applied to health care, but he argues that the three-pillar metaphor is still a fruitful perspective because it facilitates constructive responses to the pressures confronting Canada’s health system and illuminates interactions between the pension and health systems. Hence his title “six pillars of social policy”. Based on his examination of Canada’s pension and health-care systems, Robson makes a number of recommendations. First, he advocates more prefunding in both the pension and health areas to cover the future cost of the aging baby-boom cohort. Second, he recommends a gradual increase in the normal age of eligibility for pension benefits. Third, he recommends the creation of a second pillar, a mandatory contribution scheme in the health area as a way to avoid the development of a means-tested system that would exacerbate the disincentives to work and save. Fourth, he puts forward the idea of a new type of saving vehicle that provides tax-relief on distributions rather than on contributions so that Canadians can avoid the high marginal effective tax rates associated with means-tested programs.