Case Study 101
Imagine you’re a cancer patient. You’ve been undergoing treatment for almost a year now—a combination of radiation and chemotherapy. Finally, after months of fighting, these treatments have nearly eliminated all of the cancer from your body. With only a few more treatments, your doctors are confident you’ll be able to be declared cancer-free. Now, imagine one day you turn on the news to find that the government will no longer be paying for your cancer treatment. The government’s argument? That this kind of service is “clearly not benefitting all citizens”. Your treatments are to be suspended and you’re left with no other options.
This is ludicrous, isn’t it? Of course, no government in their right mind would halt treatment for a disease with readily accessible treatment options, right?
Enter Universal Basic Income.
What is Universal Basic Income?
Universal Basic Income (UBI), has a history that dates back to Thomas More’s Utopia in 1551, where, among other things, More argues that every person should receive guaranteed income.
The premise of UBI is simple: instead of providing citizens supplemental income and social security through an array of programs like welfare, old age security, and unemployment insurance, the government instead gives a lump sum payment every month. While various trials around the world have mostly offered UBI to citizens in lower income brackets, a nationalized UBI would, in theory, provide a basic income to all citizens regardless of their income, education, or profession. In Canada or the United States, a theoretical UBI system would provide each adult approximately $1000 monthly; not enough to fully support an unemployed individual, but enough to ensure that those with low incomes don’t struggle just to make ends meet.
Of course, UBI is not without controversy. Providing “no-strings-attached” money to all members of a society (include the wealthy) seems challenging, if not a little crazy. After all, who is going to pay for this? Won’t this just encourage laziness? Put simply, supporters of UBI argue that such a system would increase worker productivity and economic output, eliminate the administrative costs of running multiple welfare agencies, reduce healthcare spending, and reduce the stigma of receiving government support. Supporters also argue that all of these benefits, in addition to raising corporate tax rates and closing tax loopholes, would result in more than enough money to finance a full-fledged program—estimated to cost $43-billion annually in Canada.
Over the years, the idea of UBI has been tested around the world in several capacities, including ongoing projects in Scotland, Finland, and Kenya. Contrary to the belief of many skeptics, in each of these studies, researchers found the money doesn’t cause poor people to give up work. Instead, people invested in improving their own lives and the lives of their families. Things that were just out of reach—like sufficient food, quality healthcare, and education—suddenly became accessible. Although the merits of UBI continue to be debated, when coupled with other policy solutions such as a federal jobs guarantee, UBI has the potential to dramatically change the way nations address poverty.
UBI and Health
Poverty, like cancer, is a chronic disease. The effects of poverty and cancer don’t last for months, but instead impact the lives of those affected for years, decades, and maybe even their entire lives. These diseases often don’t have one discernible trigger, and remit and relapse throughout one’s life for no apparent reason. In medicine, things like income and poverty belong to a collection of factors known as the social determinants of health (SDH). In the case of inadequate income, the stress associated with this can cause a negative ripple effect to all elements of one’s life. Poverty has been implicated as a contributing factor to poor childhood development, mental and physical health problems, and an inability to access to healthcare services. Furthermore, treatments for the health-related impacts of poverty remain elusive. UBI represents one potential solution.
Particularly when it comes to healthcare, past and present UBI trials have shown that UBI has the potential to dramatically reduce the health inequities that remain pervasive in our society. Alaska, home of the Alaska Permanent Fund, reports 14% decreased likelihood of low birth weight compared to other US states. In Kenya, youth experienced 24% less depressive symptoms alongside reports of feeling healthier and more hopeful. In Manitoba, an 8.5% decline in healthcare utilization and decreased hospital visits for psychiatric reasons were reported.
The Ontario UBI Pilot
Given the immense potential of UBI to address a slew of issues, in 2016 the Ontario Government under the leadership of Premier Kathleen Wynne developed a UBI pilot program. This $150-million, three-year program, which took place in a mix of urban and rural locations in the Hamilton, Thunder Bay, and Lindsay areas, enrolled 4,000 low income participants to receive a combined yearly UBI stipend of $17,000 for a single person or $24,000 for a couple, minus 50% of any yearly earned income from those actively working. This group was then compared to a control group 2,000 participants not receiving any monthly UBI payments. Overseen by researchers from St. Michael’s Hospital and McMaster University, the study was meant to investigate the impacts of UBI on those living on lower incomes with regard to food security, stress, anxiety, mental health, housing stability, and a slew of other health-related factors.
After less than a year of formal operations, and despite the remarkable amount of promise UBI holds, the Ford government formally announced its intentions to “wind-down” the basic income pilot project in August 2018. Asked about the cancellation of the UBI pilot, Children, Community and Social Services Minister Lisa Macleod said that the project was expensive and that “it really is a disincentive to get people back on track”.
Saying that providing extra income to citizens encourages dependence on the government is akin to saying that needing treatment for cancer encourages dependence on the healthcare system. Nobody seeks cancer treatment because they wish to be there forever. People seek cancer treatment because it is their only option to becoming healthy again. Likewise, nobody relies on programs like UBI because they want to be dependent on government support. People rely on programs like UBI because it is a path to financial independence. To further counter the government’s narrative, the PC government chose to cancel this project before any meaningful data was able to be collected. Meanwhile, as previously mentioned, past UBI trials have shown that UBI empowers its recipients to find work — hardly the disincentive the Ontario government says it is.
Ultimately, this decision by the Ford government, much like their decision to once again “review” the merits of safe injection sites, (see James Payne post on SSIs) is the wrong one. The cancellation of the UBI pilot will rob the entire world of important data needed to assess the merits and implementation of UBI on a broader scale. Furthermore, this decision will further disadvantage our most vulnerable citizens. It will result in worse healthcare outcomes and it may very well cost lives. And for a government that prides itself on being “for the people”, these kinds of decisions are anything but.
Author: Zachary Weiss
Zach Weiss completed his B.Sc. in Microbiology & Immunology at UBC in Vancouver. Over the years, Zach has become increasingly fascinated with the world of politics and policy, and has spent way more hours listening to political podcasts than he’s willing to admit. As a first-year medical student at Schulich, He’s particularly interested in merging his interest in politics and policy with his growing medical knowledge to advocate for and bring awareness to issues that are often overlooked.