Escaping poverty by doing your taxes

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It’s tax season in our family medicine clinic.

Seriously.

You might think it’s coronavirus all the time in family practice these days. But, being family doctors, we see the full picture of health – what causes illness, what prevents it, and what keeps us happy and well.

And that’s why we’re excitedly preparing for the annual tax clinics we run for our patients.

Obviously, we’re as obsessed with COVID-19 preparations as everyone else. But we’re also acutely aware that many of our patients don’t have the means to run to a big box store for a 14-day emergency supply of provisions for quarantine (like I did last weekend).

We’re acutely aware that our patients who couldn’t afford their medications last month still can’t afford them this month. Their bodies are being eroded by the same chronic diseases they were before this outbreak.

And the young, physically healthy couple I worked with in my homeless shelter clinic last week is still more threatened by a lack of access to enough food or a safe place to sleep than this virus.

But why taxes?

Most people see taxes as a necessary evil – handing hard-earned money to faceless bureaucrats to run programs and services they use but barely notice. Most of us understand that taxes keep our society functional but hate seeing them taken off our paycheques.

What most of us don’t imagine is that doing taxes can be a powerful way to increase income, especially for those who earn the least.

Let’s take my patient Ahmed. He’s in his late 30s, a single father of two young girls. He earns $14000 a year working part time at a minimum-wage job. That’s all he’s able to manage between childcare and a lack of Canadian experience in his field of expertise.

He spends $800 a month on rent for a small one-bedroom apartment, leaving him with almost nothing to buy food or clothes, let alone ‘extras,’ like taking his girls to the movies or buying them birthday cakes.

He and his family live in deep, deep poverty.

I saw him regularly and treated him for a range of ailments – arthritis in his hands, recurring depression, early diabetes. He stuck to treatment plans but his health was clearly on a downward spiral.

Ahmed hadn’t done his taxes for years. He knew he wouldn’t owe the government any money and he was confident the Canada Revenue Agency wouldn’t consider him a high priority target for review.

One March day a couple of years ago, I suggested he attend our tax clinic.

He found the time to come the next Saturday morning and, to his shock, he qualified for almost $19000 a year in benefits through Canadian and provincial social programs. His income suddenly more than doubled.

Ahmed’s extra money came through a range of programs – child benefits along with a range of tax credits.

All he had to do was file his taxes.

And this intervention brought his family nearly to the poverty line. It had a visible and immediate impact on his health and the health of his daughters. And it gave him the breathing room to reconfigure his life, allowing him to qualify for and find a better job, move to a better apartment, and start to give his children a semblance of stability and hope.

We’re not the only health clinic offering tax clinics. A coalition in Winnipeg has helped low-income people access millions of dollars in benefits over the last few years.

And other health centres are actively working with their patients to access the network of free income tax clinics for low-income people supported by the CRA and community agencies across the country.

For those earning up to about $35,000 a year, filing taxes can result in a growth in income.

For me as a doctor, it’s stories like Ahmed’s that make me proud to pay my taxes and remind me of the power of social programs to support the health and well-being of those most in need.

And it’s stories like Ahmed’s that make us excited, in our family medicine clinic, when tax time rolls around.

Gary Bloch is a family physician in Toronto and an associate professor with the University of Toronto.

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