Advocating for a Basic Income Guarantee Dr. Lisa Simon, Associate Medical Officer of Health CPHA, June 13, Leadership and influence: Building capacity for policy engagement

PHO eight steps to developing a healthy public policy Focus on: 1.Describe the problem 2.Assess readiness for policy development

Health inequities

Basic Income (BI) / Guaranteed Annual Income (GAI) Regular, reliable distribution of money from government to people to help ensure total income sufficient to meet basic needs, regardless of work status Can be distributed on a universal basis (demogrant), or conditional on income using the income tax system (negative income tax / refundable tax credit) Programs approximating BI: Canada Child Benefit, Working Income Tax Benefit, Old Age Security & Guaranteed Income Supplement

Key Public Health Rationale For BI 1. Poverty: Basic income could be an effective, dignified, and efficient part of a comprehensive poverty reduction strategy. 2. Income inequality: Basic income could help close the gap in income and personal opportunity. 3. Precarious employment: Basic income could increase social security given substantial labour market changes and uncertainty.

Key BI Evidence & Experience Canada’s GAI field experiment: Mincome, % decrease in hospitalization rates for participants vs. controls, and decline in physician contact International BI programs and pilots Child benefits and seniors benefits in Canada: Have led to demonstrated health improvements Well accepted programs

Readiness for Policy Development Driving ForcesRestraining Forces  PH: SDOH well accepted, ready for new concrete policy ideas?  PH: new area of learning and engagement  PH: community collaborations on poverty  PH: capacity, opportunity costs  Policy: provincial commitment to address poverty  Policy: harms?, competing policy ideas?  Policy: trends in precarious employment  Policy: provincial/federal cost  Policy: long history of expert and political support for BI  Policy: logistics  Policy: growing public & political interest in BI, across spectrum

Recent Advocacy Context Continued resurgence of support from politicians, citizens, & international progress Public health involvement in Ontario, : Health organizations: resolutions, local advocacy Physicians’ letter Feb 2016: ON basic income pilot announced

What Went Right So Far? Based on Kingdon’s Multiple Streams Framework

Key Learnings Public Health has respected voice in the SDOH – problems and interventions Collaborate within and across sectors, and capitalize on that weight Link with a policy entrepreneur when possible Timing matters but is hard to predict, so be ready