Related to Ontario’s Basic Income pilot project there will be a lively 2 day panel discussion Oct 19, 2017, 7-9 pm followed by a Q&A at University of St. Michael’s College, in the COOP section of Brennan Hall, 81 St. Mary’s street, Toronto Ontario. Then Oct 20, 2017 also in the COOP section from 9 am to 5 pm,, there will be a Multi-Faith perspective on Basic Income entitled the Case for Solidarity examining employment, faith and social justice as related to a Basic Income. Both are free and registrations can be found at https://stmikes.utoronto.ca/event/the-case-for-solidarity-multi-faith-perspectives-on-basic-income/ Or
Why it’s useful to see Basic Income through the lens of Population Health Intervention Research
Thanks in part to the health sciences, there is widespread public acceptance that being poor is bad for your health. It doesn’t take much for us to make the connections. We might expect that less to eat and poor housing conditions interfere with our ability to maintain healthy bodies and immune systems. Less money could mean no access to things like computers so that people can visit sites like Thenutritioninsider.com
to get advice on how to eat healthy and look after their bodies. It may also mean less access to the health services that could treat or prevent illness and disease.
We need to make treatments more accessible which is why using coupons from somewhere like Save On Cannabis for CBD products might enable the vast health inequality to become smaller in the future. Moreover, fewer resources might mean fewer opportunities and fewer job options. Poverty also compounds political and social injustice, with marginalized people such as women, Indigenous people and racialized groups profoundly affected by poverty. These groups often constitute much of the poor. Lastly, evidence suggest we suffer the psychological consequences of living in material deprivation, both in absolute terms and relative to others. Therefore it is a necessity for marketing cbd brands to change the narrative around cbd products so that there’s a change in the structure and more people get accessible medical care.
The immense research on poverty, income inequality, and the social determinants of health culminated in public sympathy for the plight of the poor. Yet for all the studies that have been done on poverty, perhaps it is time to develop research and public support for a solution – such as Basic Income. There are practical challenges to getting basic income into common public health parlance. The health of everyone is highly important, no matter the level of wealth, every person should have access to healthcare, for example, men may need sexual health medications (), which means that they must be able to have that access when required by their doctor.
The answer may lie in the understanding of Basic Income as an ideological proposal that can affect our health. The discourse around basic income as a deeply ethical idea is necessary, but perhaps insufficient. I believe we should consider reframing the concept concretely as a population health intervention.
Why call basic income a “population health intervention”?
A concept advanced by Canadian researchers Potvin and Hawe (2012) as being policies or programs that shift the distribution of health risk by addressing the underlying social, economic and environmental conditions, population health intervention research is a unique approach to figuring out how we are affected by policies that have a wholesale effect on people. Eminent basic income economist Dr. Evelyn Forget took this approach in her paper “New questions, new data, old interventions: The health effects of a guaranteed annual income” (Forget 2013). She used old administrative data from the well-known “Mincome” experiment in Manitoba, and looked at health records from the same time-period. She saw a reduction in hospital burden relative to a similar town’s health care use that did not get the income grant.
Calling basic income an intervention means that we can treat it as a ‘natural experiment‘.
We can study the impact of a policy on our health and well-being without necessarily running a Randomized Controlled Trial (where you randomly assign some people to a treatment, policy, or program, and not others).
Many have proposed that we need to conduct this sort of formal scientific experiment first. Some have questioned how useful such limited studies would be. A Randomized Controlled Trial might tell us whether basic income works in a certain social, economic, and political setting, but tells us little about whether the policy would work in other settings, or why the policy had a particular effect.
We ought to be careful not to set ourselves up to fail with studies too narrowly drawn in scope. Mixed or unexpected results from such studies also risks misinterpretation, and can be used to prevent basic income from entering policy.
Although the Ontario Pilot Program represents a step in the right direction, nothing stops us from advocating for the full national implementation of basic income. A host of different research and study designs would be embedded into the impact evaluation of this federal policy, on par with health care or public education. Framing a given policy as a population health intervention acknowledges the fact that many there are health-promoting aspects to programs outside of health care sector (Hawe and Potvin 2009).
Basic income is such a policy. Programs to alleviate poverty lie outside the doctor’s office, but nevertheless have a profound impact on health.
Population Health Intervention Researchcompels us to think bigger than ourselves.
Traditional medicine treats the individual person. If we are looking at the effect of social programs and policies, this unit of analysis is often too small to see measurable differences in any single person. Moreover, if we restrict a given treatment or social program to the poorest people – such as welfare, we may see limited overall benefits to the population as a whole.
Epidemiologist Geoffrey Rose recognized this problem (Rose 1985). Imagine that people lie on a continuum of ‘risk’ for certain diseases and health outcomes. For example, this could be said of high blood pressure as a risk factor for heart attack. Higher blood pressure puts you at higher risk of heart attack.
For our purposes, let’s say this distribution represents the relationship between poverty and getting sick. Higher poverty puts you at higher risk of ‘sickness’. We might expect that most people lie somewhere in the middle of the distribution, while those at very high or very low poverty sit somewhere at the tails.
Rose noted that traditional medicine’s approach was to target high risk people at the far right. However, these people are a smaller proportion, and paying attention only to them might not give us the biggest bang for our buck. Instead, he posited that interventions that reach entire groups of people would ‘shift’ the distribution itself. At the end of the day, he estimated that these far-reaching treatments would have a bigger impact overall (Rose 1985).
Basic income fits that profile – a social policy that brings everyone up, effectively ‘shifting’ the distribution. In order to examine policies that lend a helping hand to everyone, we need a scientific lens that is broad enough to capture the whole picture. Reframing basic income as a population shifter might fill that void.
Lastly, population health interventions allow us to redirect our thinking from the problem to the solution.
We keep studying poverty, not the fixes for poverty. A population health intervention approach calls for the health sciences to consider the potential gains to be made by studying the impact of income interventions on population health. We should be turning our attention from studying how poverty effects our health, to studying how fixing poverty effects our health.
You might be quick to point out that we have not eradicated poverty yet. So, how do we study this state of affairs, when it doesn’t yet exist?
In some ways, we can. We have the pilot run in Dauphin, Manitoba that in many ways, was ahead of its time. Dr. Forget was the first to recognize the strength of “intervention-alizing” the Canadian basic income experiment. We can also examine policies that get close to basic income, such as the Bolsa Família program of Brazil – a conditional cash transfer available to families with children. In Canada, the non-conditional income grant for senior citizens called the Old Age Supplement has been analyzed as an analog to basic income (McIntyre, Kwok et al. 2016) and indeed, those researchers found that participants eligible for OAS reported better self-reported physical, mental, and function health. Importantly, they also found those on OAS (which is non-conditional) where better off than those on conditional income programs. These are innovative approaches to the question of basic income’s potential impact, using information we already have. And, it might move us from studies of poverty, toward studies of basic income.
As it stands, promoting basic income as a population health intervention for the sake of our health is underutilized, yet it seems like a sensible way to communicate the idea. Poverty is intricately tied to the material conditions of our lives and societal position in the world, predicated on sex, race, and class. How a policy like basic income works among these conditions deserves no less than comprehensive and holistic look at how our health is profoundly impacted. Research that is based on an understanding of population health intervention attempts todo just this – and capture the value and differential effect of these interventions, the processes by which they bring about change and the contexts within which they work best (Hawe and Potvin 2009).
The Dauphin Experiment and the impending Ontario Pilot have and will continue to shape our thinking moving forward. They are also a testament to the desire of Canadians for a better, kinder, healthier society for all. However, we have not yet fully transformed the public’s conception of poverty alleviation as a necessary policy, worthy of widespread implementation as are universal health care, public education, or social assistance.
Implementing a basic income as an essential social program and for our health is possible, and fully within our experience of policy-making at both the provincial and national levels. The time has come to make this a reality.
Sarah M Mah is a PhD student in the department of Geography at McGill University. She is also a member of the Asian Women for Equality Society, an organization dedicated to the campaign for a Guaranteed Livable Income.
The opinions expressed above are not necessarily those of BIEN or BI News.
References
Forget, E. L. (2013). “New questions, new data, old interventions: the health effects of a guaranteed annual income.” Prev Med57(6): 925-928.
Hawe, P. and L. Potvin (2009). “What is population health intervention research?” Can J Public Health100(1): Suppl I8-14.
McIntyre, L., C. Kwok, J. C. Emery and D. J. Dutton (2016). “Impact of a guaranteed annual income program on Canadian seniors’ physical, mental and functional health.” Can J Public Health107(2): e176-182.
Rose, G. (1985). “Sick individuals and sick populations.” Int J Epidemiol14(1): 32-38.
I was recently listening to a talk show on public radio. The first segment was about President Trump’s tax proposals. It included a debate between a supporter of Trump’s plan and an opponent of it. The supporter is associated with the Manhattan Institute, a conservative think tank. Her conclusion was that Trump’s proposed tax cuts would be great because they would lead to more economic growth and, therefore, more jobs. This is, of course, the supply-side/trickle-down economics reasoning, which could be a subject of debate itself.
A later segment on the talk show focused on New York City’s attempt to persuade Amazon to set up its headquarters in the city. For those who may not be aware, New York City’s mayor is widely considered to be politically progressive. If you are more familiar with European politics, you can think of him as something like a Social Democrat. He did not appear on the radio program, but one of his deputies did. The deputy said a primary reason the city wants to attract Amazon is that such a move would generate a lot of jobs.
Thus, there was a representative of a progressive mayor and a conservative, both of whom argued for two very different proposals on the same basis — jobs. This is not that unusual. The U.S. political Right and Left disagree on plenty: tax cuts, the proper role of the federal government, how best to improve U.S. schools, what the U.S. Constitution says about the right to own a gun, and a host of other issues. But both sides can always be counted on to agree that whether someone has a job or not is an issue of utmost importance.
Conservatives may argue that the best way to generate jobs is for the government to get out of the way and let businesses “do their thing.” Progressives may counter that the private sector will never create enough jobs for all those who desire one, and that the only way to assure people can find work is for the government to guarantee a right to work, even if it must do the hiring. But for both sides of the U.S. political spectrum, jobs are what matters.
It makes sense that both the Right and Left would be so focused on jobs. The main source of many, if not most, incomes in the U.S. is a wage or salary. For many people, if they lost their job, it would not be long before things became dire for them. For many of those currently without jobs, things are already quite dire. It is in the nature of capitalism for most of us to toil away as “wage slaves” as the Marxists define it. But it seems that over time, this economic necessity has developed into something many people call the work ethic, but which I have come to think might better be called the job ethic. The job ethic is the culture which develops when what we have to do to survive becomes not just a source of income but also one of social recognition.
In her book Justice and the Politics of Difference, the late philosopher Iris Marion Young has an essay on the definition of “oppression.” That essay is called The Five Faces of Oppression, and one of those “faces” is marginalization. Marginalization is what happens to the involuntarily unemployed. Obviously, those faced with this situation have a serious financial problem, given that they are living within a system which requires them to have money to meet their needs. But, according to Young, this is not the main reason involuntary unemployment is oppressive. The main reason is that those who are unemployed lack something which grants them access to being recognized and esteemed by their fellow citizens/residents — a job. It is this lack of a job which makes the unemployed feel cast aside and marginalized. The fact that someone is not willing to hire them results in their feeling socially worthless.
Being a philosopher/political theorist, Young does not support her argument with figures and statistics. But I think she may be onto something. A number of opponents of basic income seem to think so, too. Anyone who has followed the basic income debate has heard the argument that basic income is imprudent public policy because it would result in less work. Less work would mean people would be less inclined to engage in an activity which provides them not just with income, but also with meaning and social recognition. What these individuals are really saying is that basic income is bad social policy because it would result in fewer people having to obtain meaning and social recognition from what they have to do to “put food on the table.”
In the past, I have questioned whether basic income would have this effect. But I’m also inclined to wonder: So what if it does? As important as making a living is, humans do a lot of other things besides sell their labor. They spend time with children, spouses, and friends, they enjoy hobbies of various kinds, they engage in pursuits of higher learning, they become involved in civic pursuits to make the world a better place, and a host of other things. Can’t at least some of these things be sources of social recognition, as well? As long as capitalism and tasks that cannot be completed by machines exist, there will be a need for humans to sell their labor. But if a basic income freed some of us up to spend more time doing other things which provide us with social recognition, would that really be so bad?
About the author:
Michael A. Lewis is a social worker and sociologist by training whose areas of interest are public policy and quantitative methods. He’s also a co-founder of USBIG and has written a number of articles, book chapters, and other pieces on the basic income, including the co-edited work The Ethics and Economics of the Basic Income Guarantee. Lewis is on the faculties of the Silberman School of Social Work at Hunter College and the Graduate and University Center of the City University of New York.
Social Justice Ireland examines the fairness of seven different options for tax changes in their new publication released on Wednesday 4th of October. The new Irish Budget will be announced next Tuesday, 10th October, and the Social Justice Ireland analysis shows that much of what is being proposed is unfair and unjust. Fairer options are identified in the publication referred.
On the 11th of October, a Budget Analysis Seminar will take place, over which Social Justice Ireland will present a full Budget 2018 Analysis and Response, at 11am in Buswells Hotel. The seminar briefing will get behind the numbers and examine the impact of the choices Government makes in a variety of areas including taxation, social welfare, health, ODA and education. The analysis will identify who gains and who loses as a result of Budget 2018. There will also be an opportunity for questions and discussion. The event is free but pre-registrations are compulsory (registers here).
The 17th BIEN Congress took place in Lisbon, Portugal from the 25th to the 27th of September. The focus of the congress was on “Implementing Basic Income.” The 150 presenters represented 33 countries, with more countries represented in the additional 380 audience members. According to Karl Widerquist, Vice-Chair of BIEN, this may have been the largest BIEN Congress since Brazil in 2010. The Congress included keynote presentations by BIEN co-founders Guy Standing and Philippe Van Parijs, in addition to keynote presentations about several Basic Income pilot programs, reflecting the congress’s focus on implementation, and from several political figures who are advocating for Basic Income in their respective countries.
The first day of the congress took place at the Portuguese Parliament (Assembleia da República), and as Standing said: “I am sure I speak for many of the co-founders, and many of them are here, that when we set up BIEN 31 years ago we never anticipated that we would be in a place like this in 2017.” The second and third days were held at ISEG, Lisbon School of Economics and Management, a beautiful venue that used to be a convent (Convento das Inglesinhas, restored by architect Gonçalo Byrne) that has kept many of its original architectural features and now hosts the university’s post-graduate programs.
Starting the keynote session on Basic Income pilot programs, Evelyn Forget’s presentation was about the differences between the narratives attached to several Basic Income experiments. She underlined that different narratives will create different criteria of success. For example, Finland’s narrative is about long-term unemployment and incentivising return to work. In this case, the experiment will be successful if people return to work. Ontario’s narrative is about social justice and a gap in benefits for adults because of the new reality of precarious work and poverty issues. Their goal is to expand the welfare state. Silicon Valley’s Y Combinator’s narrative started out as an utopia put forward by private individuals who wondered what would happen once automation freed people to do what they want. Forget stressed that “context matters” in pilot programs, and she suggested that when we bring together all these shared experiences, we can create newer and richer narratives.
After Forget’s insights, there were several presentations about specific pilot programs being developed. Karen Glass, from the experiment in Ontario, Canada, described the pilot program as a type of Negative Income Tax program, since the payments decrease as the recipients start working. The Ontario project applies to households and encompasses individuals aged 18 through 64, who have been residents of the region for one year. The pilot provides a guaranteed annual income of $17,000 dollars per individual and $24,000 per couple, which is 75% of the low income measure. The success criteria are not focused primarily on work incentives, but on recipients’ improved health, reduction in anxiety and the ability to make ends meet. Elizabeth Rhodes from Y Combinator, a seed investment company, talked about the contours of what this private experiment wants to achieve. Y Combinator has already financed a feasibility study in Oakland. and now plans to select 3000 participants who will receive 1000 dollars per month, some for three years and others for five. There is an income cap in the selection and they will be undersampling higher incomes. Presently the program is considering selecting subjects 21 to 40 years in age. The pilot intends to evaluate well being, mental and physical health, social and civic engagement and social networks effects as well as effects in the children of the participants. The research team has been piloting and testing their methods with a smaller group of participants.
Joe Huston spoke about the experience of GiveDirectly in Kenya. GiveDirectly has raised funds privately and has been distributing them to around 100 people, but once the project is fully launched there will be up to 26,000 people receiving some type of cash transfer. The pilot is divided into three groups, one group will receive a monthly payment for 12 years, another for 2 years and yet another will receive a one time cash grant of the same amount. The 100 people who are receiving a monthly Basic Income already have reported on their experiences, and, as Huston says,many have reported they did not reduce their work efforts; instead, many have several projects that need to be completed (such as paying for school and building a house), so they need to work. Others have pulled their Basic Income payments together in something called “table banking” and give a larger sum to each member at a time so that more can be achieved. Giving to individuals as opposed to households has had the emancipatory effects that are often theorized: because each person receives an equal amount of money, it is easier to solve household disputes. Regarding how the money is spent, Huston says that Basic Income debates seem to oscillate between saying that people will become lazy bums or startup engineers; however, both extremes are inaccurate and do not apply to what is happening in the village so far. Huston explains that when walking from house to house in Kenya one can see a diversity of life choices: “Irene spent some in purchasing a goat for about $12 and kept some of the money as savings. Eric spent most of his money in a fishing net, saved some of the money and bought small fish like anchovies for a snack. Frederick spent most of the money in school fees.” So far, each person used the money as is more adequate in their particular circumstances.
On the political arena there were several important participants. From Germany, Cosima Kern spoke about the new Basic Income single issue party, and explained that since Germany has no direct democracy (in contrast to Switzerland) this is a way to force Basic Income into the political arena. The Basic Income party had almost 100,000 votes in the election that took place on day before the Congress, which Kern said is a good result for a new party. Enno Schmidt talked about the referendum in Switzerland and also underlined that the 23% vote for Basic Income was a great first result, reminding everyone how it took 17 years of discussion in Switzerland for women to have the right to vote. Lena Stark spoke about the new political party in Sweden in the same vein as the German party; they plan to run for elections in September 2018. Ping Xu presented the situation in Taiwan with the help of Tyler Prochazka. Taiwan has the highest housing costs and the lowest birth rates, and would be an ideal site for a full implementation of Basic Income. From Japan, the ex-Minister of Agriculture, Masahiko Yamada, spoke about the importance of Basic Income in his country, which is facing new economic challenges that urgently need to be addressed.
Finally, the Scottish MP Ronnie Cowan inspired the audience with his privileged viewpoint regarding how politicians tend to operate and the heartfelt way that Scotland is pursuing their Basic Income pilot programs. Mr. Cowan said that politicians rely on experts, but experts and academic often disagree, and politicians need facts and figures, which is why experiments are so important. With pilot schemes, we can monitor outcomes; they can be used to tell if “people are happier, more socially engaged, eating healthier, if kids are doing better at school, we can measure the benefits against the cost.” Mr. Cowan concluded: “Basic Income really comes alive for me when we consider it’s for everyone. It is not means tested. It is not subject to the disability test. It removes stigma. It creates choice and it’s absolutely dripping in humanity.”
The two main keynote speakers, Guy Standing and Philippe Van Parijs, also captured the audience’s interest with their presentations. Standing celebrated the 800 year anniversary of The Charter of the Forest, a piece of legislation that was valid for 754 years, only repealed in 1971. Standing argued that the commons defended in The Charter of The Forest have been plundered upon for hundreds of years, and Basic Income is a way to bring back the commons. He defended the position that Basic Income should be seen as a social dividend based in the commons and land tax, not something that will send income tax through the roof. Van Parijs spoke of the right to work and the duty to work. He argued that even though many see Basic Income as an attack on these, it actually facilitates both. Basic Income can organically encourage part-time work and therefore job sharing, thus promoting the right to work. Basic Income can also allow for the duty to work to be expressed in a meaningful way that includes paid and unpaid jobs. According to Van Parijs, the duty to work cannot mean simply doing something for a salary; it should be viewed more widely as a duty to participate in society in a meaningful way. Basic Income can liberate people to participate in such a way by either allowing them to chose paid work that is more meaningful, or by choosing other unpaid useful work. If we eliminate the idea that people have to work in whatever they can to survive, the morality of what one chooses to do will come to the forefront, allowing the duty to work in a more meaningful way to become center stage as far as human activity is concerned.
The keynote presentations wrapped up with Eduardo Suplicy from Brazil, ex-Senator and long time defender of Basic Income, and Francisco Louçã, member of the left wing party Bloco de Esquerda in Portugal. There were also many other local Portuguese participants, as well as a slew of media attention related to the congress (which will be discussed in a future Basic Income Newspiece). The congress also included 37 parallel sessions, among others, Malcolm Torry’s presentation on Defining Basic Income, sessions on Degrowth, Digital Economy, Communicating about Basic Income, and many other topics, as well as two films, Christian Todd’sFree Lunch Society and Rena Masuyama’s Film Project, the first fiction film about Basic Income produced in Japan. Summaries of all the sessions provided by the chairs should be available in about one month at the Portuguese Basic Income Site, for now there are papers and presentations and videos of the event available of the site.
