Reform: Addressing Taboos of Redistribution, Social Spending, and Managing the Market Economy

Lynch presents three public policy taboos among contemporary policymakers that make achieving health equity by reducing health inequalities difficult: redistribution, social spending, and managing the market economy. 179 These taboos are important in liberal welfare states as indicators of redistribution, social spending and managing the market economy fall well below all social democratic welfare states and most conservative ones. 4 Many health equity researchers and advocates work for reforms within existing systems with remarkably consistent pleas for public policy action. 180

Regarding redistribution, proposals include increasing progressivity of the tax structure and promoting universal programs linked to greater social spending on family benefits, pharmacare and denticare, job training, pensions and social assistance and disability benefits. 180 For managing the market economy, workplace legislation and regulation related to employment security, working conditions, and wages and benefits are required. Nations can enable the unionization of workplaces and the extent of collective bargaining through sectoral and intersectoral employment agreements which also serves to manage the market economy. Nations can legislate employment security by managing lay-offs and terms of part-time and temporary employment. Liberal nations provides little of this. 181