Climate change, taxes and health: getting government back to work on its most urgent business

Before the recent federal election, the 3 issues that mattered most to Canadians were reportedly health care, climate change and taxes (www.ipsos.com/en-ca/news-polls/Canadians-want-political-parties-to-focus-on-healthcare). Yet, in a striking display of cognitive dissonance, a CBC-commissioned poll in June 2019 found that, while almost two-thirds of Canadians thought tackling climate change was a top priority, 32% didn’t want to pay any tax toward it, and another 17% didn’t want to pay more than $100 per year (www.cbc.ca/news/politics/election-poll-climate-change-1.5178514). Canadians, assisted by the media, appear to think that climate change, health, taxes and the economy are separate. But they are not. They are intimately connected. And framing them as a single problem could help people to understand and support practical policies aimed at stalling climate change.

We’ve long appreciated that climate change threatens human health in many ways.1^,2 While the effects of climate change will pose the greatest burden to the socially and economically vulnerable, they will affect everyone. In the past few years, Canadians have seen rising deaths from heat stress and natural disasters. Climate-related effects on agriculture and traditional food sources have led to food insecurity. Infectious disease risks are changing.1 Air pollution (related to climate change through the “climate penalty” on air quality that sees warmer air temperatures raising concentrations of certain particulate matter in air) now ranks second only to smoking among risk factors for non-communicable diseases globally.3

Worldwide, climate change threatens to destabilize economies, and Canada’s will be no exception. More sick people will mean not only more costs for health systems, but also less economic productivity. People who lose their homes or their means to earn income because of natural disasters will struggle to work and may experience mental illness. Social inequities will grow, threatening people’s health, their economic security and our political stability.

Fortunately, well-conducted modelling studies have shown repeatedly that the costs of implementing policies to mitigate climate change — including appropriate carbon pricing — would be more than offset over the medium to long term for all countries, including wealthy ones like Canada, by savings incurred through what scientists have come to call “health co-benefits.”1^,4^–6 Put plainly, our society will save more in the future by avoiding the expected health effects of climate change than we will spend now on the green infrastructure, carbon taxes and personal lifestyle changes that are required to meet international targets to hold global warming below 1.5–2°C.

Paying taxes seldom feels good, especially if they’re for something from which we may not benefit directly in our lifetimes, even if our children will. Yet, most Canadians gladly contribute taxes to fund our health care system. Perhaps if governments framed the carbon tax as a tax with slam-dunk health benefits for the majority, people would find paying it to be more acceptable.

We in Canada aren’t alone in failing to appreciate the promise of the health co-benefits of policies to mitigate climate change. A recent report from the Organisation for Economic Co-operation and Development emphasized that most countries are pricing carbon too low to meet the Paris Agreement’s targets of halving global fossil fuel emissions by 2030, because current carbon pricing strategies don’t reflect the costs of carbon to the wider global economy.7 Even the seemingly ambitious Green New Deal presented to US Congress in February 2019 did not emphasize strongly that meaningful investment now to mitigate climate change would more than pay off in health gains in the long term.8

We know that health systems don’t do well when left entirely to market forces. Climate change mitigation is another good everyone on the planet needs that cannot be addressed through the market efficiently enough to avert disaster. That’s why policies with the single aim of supporting green technology innovation, that don’t add taxation and other legislation to drive change in behaviour, are naïve.

The climate emergency declared by the Liberal government in their previous term is real. What we need urgently from Canada’s new federal government is collaborative leadership to develop bipartisan support for bold, evidence-informed policies that consider health, taxation and the economy together. Only taking a “health in all policies” approach can offer any chance of addressing the extent and complexity of the need to reduce carbon emissions to globally agreed targets.9^,10

As with any health emergency, outcomes will be best if swift, effective action is taken through coordinated team effort followed by careful maintenance care. Prime Minister Trudeau’s new minority government needs support from other parties to be able to govern. There is no excuse for Canada’s political parties to drag their heels on implementing evidence-based cross-platform policies to address climate change. As physicians and health advocates, let’s hold our federal government to account to safeguard Canadians’ future well-being.