“A nation’s greatness lies not in the quantities of its goods but in the quality of its life.”
- Tommy Douglas
As a youth, Tommy Douglas was a championship boxer. His success in the ring is all the more remarkable considering that years earlier he had nearly lost his leg to amputation when an infection set in. As his many biographers point out, a travelling surgeon agreed to operate for free, as long as his parents consented to allow his medical students to watch. After several operations, he not only walked again, he thrived as an amateur boxer and then built his reputation as someone who fought for the underdog in the political arena as well.
Douglas never forgot his childhood experience and resolved that no one should have to pay for necessary medical care. His efforts are now celebrated within Canada’s history, for not only did he establish Medicare, he also established democratic socialism within the country and its politics.
While universal public health care is now taken for granted in Canadian life, there’s a new policy kid in town that aims for the same kind of social policy immortality – a basic income guarantee. A basic income guarantee ensures everyone an income that is sufficient to meet their basic needs, regardless of work status. The type most talked about in Canada is a negative income tax model, where it would be universally available to everyone during periods of financial need.
"It isn’t just physical health that is expected to improve with a basic income."
With research clearly showing that being poor affects a person’s health more than lifestyle choices, having a regular assured income for anyone to access when needed would address what is clearly the most important social determinant of health of all – income and income distribution.
As Dennis Raphael and Juha Mikkonen write in The Social Determinants of Health: The Canadian Facts, in Canada “income determines the quality of other social determinants of health such as food security, housing, and other basic prerequisites of health.”
The Push for Income for Better Health
The Canadian Senate suggests that health care accounts for at most 25 percent of health outcomes. In other words, we know that it is income and its distribution that truly matters when it comes to improving Canadian health outcomes.
That’s why many health-related organizations in Canada have stepped forward to fight for a basic income guarantee. A few months ago, 194 physicians in Ontario signed a letter calling on the Province to support a basic income pilot program. Following that, members of the Canadian Medical Association passed a motion supporting the concept of a basic income guarantee for Canada.
It isn’t just physical health that is expected to improve with a basic income. The Ontario Mental Health and Addictions Alliance has come down squarely in favour of the policy, too. In a statement the Alliance points out that a disproportionate number of people with mental illness live in poverty.
“Evidence suggests that compared to current social assistance programs, a basic income guarantee could dramatically improve standards of living and health outcomes – at less cost to taxpayers. It would be particularly beneficial for people with mental illness and/or addictions and their children,” their report notes.
Health units across Ontario have not been silent on this issue, either. The Association of Local Public Health Agencies (alPHa) is a not-for-profit organization that provides leadership to the boards of health and public health units in the province. In their resolution in support of basic income, alPHa points out that 13.9 percent of the province’s population live in low income, according to the 2011 National Household Survey after-tax low-income measure.
Perhaps basic income was always meant to be universal, and always meant to be tied to the same ideas and principles that brought us universal health care.
In 1968, the very same year that universal public health care spread out across Canada, a Special Senate Committee on Poverty reached out to Canadians to address the challenge of pervasive poverty. Chaired by Senator David Croll and unflinchingly written, it declared even then that Canada was ready for a basic income guarantee:
“It is the Committee’s recommendation that the Parliament of Canada enact legislation to provide a guaranteed minimum income for all Canadians with insufficient income. This includes the…unemployed, those whose incomes are too low because they work in seasonal occupations, and those who are victims of jobs where the pay is insufficient to provide for their basic needs.”
"Tommy Douglas once stepped into the ring on behalf of the people of Saskatchewan and eventually walked away with universal health care for all."
In fact, one of the authors of the report, Michael Clague, told social purpose news site, Leaders and Legacies, that basic income should come to be seen as a core Canadian value, just as universal health care has become.
“If it’s understood that all Canadians, like we have with health care, are assured of core financial security if they get in trouble, it makes it more saleable.”
Selling it is what advocates have been busy doing, especially within the last two years. Their efforts appear to be paying off.
In its recent budget the Government of Ontario has pledged to “work with communities, researchers and other stakeholders in 2016 to determine how best to design and implement a Basic Income pilot.”
The budget also states that, “The pilot project will test whether a basic income would provide a more efficient way of delivering income support, strengthen the attachment to the labour force, and achieve savings in other areas, such as health care and housing supports.”
In Quebec, François Blais, the minister of employment and social solidarity, has been asked by Premier Philippe Couillard to figure out how the province might turn their existing income support tools in the direction of a basic income guarantee. Blais is well positioned to do so, having written a well-received book called Ending Poverty: A Basic Income for All Canadians.
At the federal level, Jean-Yves Duclos, federal minister of families, children and social development, has stated that a guaranteed minimum income is a policy worthy of discussion, opening the door to possible federal involvement.
Tommy Douglas once stepped into the ring on behalf of the people of Saskatchewan and eventually walked away with universal health care for all. Ultimately, it will be Prime Minister Justin Trudeau who will have to decide if he wants to deliver basic income and the resulting health benefits to all Canadians.
Perhaps it is meaningful that our current prime minister is also a boxer. With the rise of precarious work due to automation and globalization, an economy in need of reform, and persistent poverty, he may come to realize that basic income, and the health of Canadians, is a prize worth fighting for.
Roderick Benns is the publisher of Leader and Legacies, a non-partisan news site with an emphasis on progressive social policies. He's an award-winning journalist, former senior writer with the Literacy, Numeracy Secretariat of the Ontario Ministry of Education and the author of several books.