HEN: Canada (Sub-Topic)最新文献

{"title":"First Peoples Lost: Determining the State of Status First Nations Mortality in Canada Using Administrative Data","authors":"D. Feir, Randall K. Q. Akee","doi":"10.1111/caje.12387","DOIUrl":"https://doi.org/10.1111/caje.12387","url":null,"abstract":"We present the most comprehensive set of estimates to date for Status First Nations mortality in Canada. We use administrative data from Indigenous and Northern Affairs Canada to establish a set of stylized facts regarding Status First Nations mortality rates from 1974 to 2013. Between 2010 to 2013, the mortality rates of Status First Nations men and boys are highest in nearly all age groups considered with the exception of Status girls between the ages of 10 to 14. On reserve, Status boys between the ages of 15 to 19 have mortality rates nearly four times that in the general population, while Status girls between the ages of 15 to 19 have mortality rates five times that in the general population. We demonstrate substantial regional variation in mortality rates which are correlated with economic factors. We document that there has been no improvement in mortality among Status women and girls living on-reserve in the last 30 years and relative mortality rates for all Status people on-reserve has not changed in 40 years. Mortality rates may be worsening among some age groups. JEL Classification: J15,J16,I15,I14","PeriodicalId":392992,"journal":{"name":"HEN: Canada (Sub-Topic)","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114547987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tax-Assisted Approaches for Helping Canadians Meet Out-of-Pocket Health-Care Costs","authors":"J. Emery","doi":"10.11575/SPPP.V9I0.42592","DOIUrl":"https://doi.org/10.11575/SPPP.V9I0.42592","url":null,"abstract":"Canadians are not saving for the inevitable costs of drugs and long-term care which they will have to pay for out of pocket in their old age, and these costs could potentially be financially devastating for them. Later in life, when out-of-pocket health-care costs mount, those who previously enjoyed the security of a workplace insurance plan to cover such expenses will face a grim financial reality. Many aspects of care for older Canadians aren’t covered by this country’s single-payer health-care system. Besides prescription drugs, these include management of chronic conditions by ancillary health professionals, home care, long-term care, and dental and vision care. Statistics show that in 2012, Canadians’ private spending on health care totaled $60 billion, with private health insurance covering $24.5 billion of that amount. Coverage of health-care costs that don’t fall under Medicare’s purview is at present rather piecemeal. The non-refundable federal Medical Expense Tax Credit covers expenses only after the three-per-cent minimum, or first $2,171, of out-of-pocket costs have been paid by the individual. The Disability Tax Credit is available to those with a certified chronic disability, and these individuals are eligible for further support via the Registered Disability Savings Plan. A Caregiver Tax Credit is also available. The federal government has a golden opportunity to provide an incentive for Canadians to set aside money to pay not only for the often catastrophic medical and drug costs that can come with aging, but also to save so they can afford long-term care, or purchase private health insurance. Too many Canadians, unfortunately, believe that the federal government picks up the tab for long-term care. In fact, provincial subsidies are provided on a means-testing basis, thus leaving many better-off Canadians in the lurch when they can no longer live alone and must make the transition to long-term care. Providing more generous tax treatment of current and future out-of-pocket health costs, including insurance premiums, is an obvious way for the federal government to support Canadians to meet their health care needs and improve their well-being. Two existing vehicles can play an essential part of this plan. The government can change the currently non-refundable Medical Expenses Tax Credit and the refundable Medical Expenses Supplement so that out-ofpocket health-care costs are eligible from the first dollar. This would place no added burden on government if the exemption of employer-provided health benefits from employees’ taxable income were removed. Making an altered METC available to Canadians who pay their out-of-pocket costs from a registered health savings vehicle, which could be created within an RRSP to avoid extra administrative burdens, would provide them with an incentive to save. They could then either self-insure for future out-of-pocket health costs, or purchase private health insurance. A grant component could be added f","PeriodicalId":392992,"journal":{"name":"HEN: Canada (Sub-Topic)","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122975358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fiscal Sustainability of Alberta's Public Health Care System","authors":"L. di Matteo, R. Matteo","doi":"10.2139/ssrn.3046639","DOIUrl":"https://doi.org/10.2139/ssrn.3046639","url":null,"abstract":"From 1975 to 2007, Alberta’s real per capita government health expenditures grew from $1,679 to $3,696 (in 2007 dollars), at a median annual growth rate of 3.5%. Over the same period, Alberta’s real per capita gross domestic product and real per capita total government revenues grew at median annual rates of 2.2% and 1.7%, respectively. This difference between the growth rates of health care spending on the one hand and government revenues and the economy on the other gives rise to concern about the fiscal sustainability of the province’s public health care system. This study presents projections of real per capita spending on public health care in Alberta over the medium term out to 2030. They suggest that, by then, real per capita spending could reach anywhere between $5,339 and $14,215, soaking up between 32% and 87% of total government revenues; more worrying, the high end of these ranges reflects a continuation of the policy settings that guide current provincial public health spending. Alberta is fortunate to have a wealthy economy that can support a high level of public health spending. But that support is precarious given the cyclical nature of non-renewable natural resource revenues and Alberta’s past tendency to experience periods of boom and bust. Basing the financing of key spending programs such as health care on a volatile revenue base is not advisable, for it puts them at risk should economic conditions turn unfavourable, as they have recently. Indeed, adjusting government revenues in our projections to match a more reasonable measure of what might be relied upon with a degree of certainty simply enhances the precariousness of the fiscal sustainability of the public health care system. Not all categories of provincial government health care spending — in particular, the traditional core medicare areas of physician services and hospitals — are growing faster than either the revenue base or the economy. The growth of spending on non-medicare categories such as drugs, capital, and all other health expenditures, however, is a particular source of concern. Options for sustaining provincial government health expenditures include choosing what other government programs could be allowed to grow more slowly over time, what tax rates could be increased to cause the revenue base to grow more quickly, and what health programs currently provided by the public sector instead could be provided privately. These approaches need not exist in watertight compartments, however, and a portfolio of policies that combines these solutions likely would be a pragmatic policy outcome. Such a strategy would help to ensure the fiscal sustainability of Alberta’s public health care system and responsibly provide for the future welfare of its citizens.","PeriodicalId":392992,"journal":{"name":"HEN: Canada (Sub-Topic)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129413524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}