Advocating for a Basic Income Guarantee Dr. Lisa Simon, Associate Medical Officer of Health TOPHC, April 5, Leadership and Influence: Achieving Public Health Goals through Public Policy

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, NIT) Programs approximating BI: Canada Child Benefit, Working Income Tax Benefit, Old Age Security & Guaranteed Income Supplement

The Health Perspective Poverty and income inequality as key SDOH Rise of precarious employment BI more effective and dignified income security approach, as part of multi-pronged strategy Manitoba GAI field experiment: Mincome, % decrease in hospitalization rates for participants vs. controls, and decline in physician contact Child and seniors benefits in Canada have led to demonstrated health improvements

The Advocacy Context Long history of expert and political support and debate Public health interest - e.g. OPHA 1992 Recent 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

Facilitators and Barriers to A/MOH Involvement Facilitators: Supportive MOH and Board of Health Public health sector interested in SDOH Barriers: Substantial time commitment No road map

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