‘An ongoing emergency’: Why public-health officials are calling for basic income

Across Ontario, public-health units are not only battling COVID-19 — but also advocating for a new post-pandemic normal
By Monika Warzecha - Published on Jul 08, 2020
Advocates for basic income say it alleviates poverty, improves health, and saves governments money down the road. (Richard Plume/CP)

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The premier of Ontario seemed to be warming to the idea of a basic income guarantee: “I don’t think it is necessary that one should work in order to be kept alive in our society.”

It wasn’t Premier Kathleen Wynne, whose government launched a basic-income pilot in 2017, who spoke those words, but Premier John Robarts, back in 1969. The idea of a basic income —  that people should have a minimum income to meet their basic needs, regardless of work status — has been kicked around by Ontario lawmakers for more than 50 years. 

The Wynne government’s experiment, which would have studied the stipend’s effect on 4,000 people in a range of urban and rural communities against a control group, was abruptly cancelled by the newly elected Progressive Conservatives in 2018 before it fully took root.

Today, as leaders around the world grapple with the twin health and economic crises of the COVID-19 pandemic, basic income is once again in the spotlight. Health officials across the province are raising their voices in support of the idea and publicly asking the federal government to evolve the Canada Emergency Response Benefit into a basic-income commitment, one that would last beyond what Prime Minister Justin Trudeau calls these “unprecedented times.” 

According to the Basic Income Canada Network, basic income isn’t welfare — it’s meant to help working-age Canadians who might otherwise have to rely on a patchwork of social-assistance services make ends meet. Those who champion basic income say it alleviates poverty, improves health, and saves governments money down the road. Critics believe it would disincentivize people to work.

The coronavirus pandemic has added an extra element of urgency to the discussion. “We've certainly seen an increase in vulnerability and a dramatic increase in income insecurity,” says Kristina Nairn, a public-health nurse with the Haliburton, Kawartha, Pine Ridge District Health Unit. 

The HKPR unit is among the public-health boards that have sent open letters to Trudeau, Deputy Prime Minister Chrystia Freeland, and Finance Minister Bill Morneau in recent months calling for a basic-income guarantee. Others include Simcoe Muskoka District Health Unit; North Bay Parry Sound District Health Unit; and the Kingston, Frontenac and Lennox and Addington Board of Health. 

Generally, the letters commend the government for setting up the CERB, the Canada Emergency Student Benefit, and the Canada Emergency Wage Subsidy, but note that too many people are still falling through the cracks. They want the CERB to “evolve” into basic-income legislation.

The Simcoe Muskoka District Health Unit, which sent a letter on May 20, received a response from the Prime Minister’s Office acknowledging the letter and saying that it had been forwarded to Ahmed D. Hussen, minister of families, children and social development.

When asked whether the federal government was considering turning CERB into basic income, a spokesperson for the office told TVO.org via email that income security is a shared jurisdiction across different levels of government: “As such, the Government of Canada recognizes the importance of working with provinces and territories to find solutions to common challenges … As we continue to move towards economic recovery, the Government of Canada is continuing to explore a variety of potential shorter and longer-term policy responses that could address the ongoing needs of Canadians.”

Some health departments across Ontario haven’t sent letters but nevertheless have a long history of promoting basic income. A spokesperson for Toronto Public Health told TVO.org via email that, while the board hadn’t made a formal request to the federal government, it has “been a longstanding advocate for income based strategies including basic income guarantee, increases to social assistance rates and minimum wage.”

Groups such as the Ontario Dietitians in Public Health are also involved in the recent push, and the mayors of Sarnia and Orillia have thrown their support behind their local health units’ advocacy. 

“Income is the key determining factor in how healthy you are, period,” Nairn says. “Because that is the case, we need to address income security so we can improve people's health and, in the long run, decrease costs and negative impacts.”

Chris Bowes, the manager of the Healthy Living program in the North Bay Parry Sound District Health Unit, says that “in a general sense, we know that the negative health consequences of social deprivation caused by insecurity and inadequate incomes include shortened life expectancy, chronic diseases, infant mortality, addictions, as well as other physical and mental health impairments.”

In Bowes’s health district, one in seven households is food insecure, meaning it has inadequate or insecure access to food because of financial constraints. Ontario-wide, one in eight families is  food insecure — and that number is expected to rise because of the pandemic. Food insecurity can lead to problems such as diabetes and high blood pressure and to mental-health issues such as mood disorders and depression, according to the Ontario Dietitians of Public Health.

Basic income is meant to help cover the basics: food and shelter costs. Nairn says that her health region faces issues similar to those of other health units across the province. But, in her area, rents have rapidly increased. So has homelessness. “If we don't first house people, then we're not going to make a difference in their health outcomes. We need to be able to give people a livable income that is at least going to allow them to have housing and food,” Nairn says. “The Ontario Works programs and the Ontario disability programs do not provide an income that allows people to afford housing and food in our region.”

Although calls to transform CERB don’t constitute a coordinated campaign, Nairn says, the individual health units do support one another in their advocacy, often referencing one another in government letters. She says it’s also part of a tradition of income advocacy among health units in the province that predates the 2017 Ontario pilot. 

“We've been advocating for a long time and then advocating again,” she says.

Dauphin, Manitoba, is a touchstone for many public-health officials. In 1974, the governments of Prime Minister Pierre Elliott Trudeau and Premier Edward Schreyer launched “Mincome,” a minimum-income program to support the working poor. About a third of Dauphin residents qualified.

The program was scrapped in 1979 amid political turnover both federally and provincially, and no final report was ever written. Decades later, health economist Evelyn Forget dug the research out of the archives and made a number of discoveries — for example, in four years, hospitalization rates from accidents, injuries, and mental-health issues dropped.

A generation later, public-health officials are asking Justin Trudeau, the son of the prime minister who helped launch Mincome, to give basic income another try.

In April, 50 senators signed a letter to Trudeau, Freeland, and Morneau encouraging MPs to restructure the CERB into a guaranteed basic income amid the pandemic. Following a request by Senator Yuen Pau Woo, the Parliamentary Budget Office released a costing report on July 7. Using the parameters of the Ontario pilot project, the PBO estimates that, based on three different scenarios, a guaranteed basic income program running from October to March 2021 would cost between $47.5 and $98.1 billion. Repealing various federal and provincial programs for low-income Canadians, as well as tax credits, would result in about $15 billion in offsets.

“Challenging times such as this can make clear the need for reform,” says Charles Gardner, the medical officer of health at the Simcoe Muskoka District Health Unit. “At this time of great income insecurity for so many Canadians, the need for a guaranteed annual income is very apparent.” 

But the latest advocacy efforts aren’t just about this particular crisis.

“I think it's really important that, when we talk about the CERB — and that being a program to support people during an emergency — that we recognize there are a number of people in our district, a number of people in Ontario, and a number of people in Canada who are living their lives in an ongoing emergency when it comes to food and adequate shelter,” Bowes says. Basic income is a “long-term solution to helping with these problems.”

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