 Thank you so much for joining us tonight for a discussion with Professors Evelyn Forgeray, Marnie Browno and Marcela Alson. And many thanks to Stanford's Basic Income Lab and the McCoy Family Center for Ethics in Society for organizing and hosting this event. My name is Olga Lentzewska and I'm a PhD candidate in the Philosophy Department here at Stanford and a grad fellow at the Basic Income Lab. I'm a research focus on the notion of political pluralism and the writings of Emmanuel Kant, John Rose and other thinkers belonging to the social contract tradition of political thought. My interest in pluralism has led me to become fascinated with UBI as a proposal that attracts people with many different values and beliefs. At the lab I'm currently working on the mapping of basic income literature by theme for the creation of an online user-friendly visualization. This visualization will promote more methodical progress in the academic field of UBI and builds a rigorous platform for the benefit of future basic income experimenters, researchers, students and policymakers. I'm sure that many of you are already familiar with the idea of universal basic income. While it's an old idea it has been revived in recent years and enjoys a growing popularity. The idea behind UBI is simple yet radical. To provide a regular crash payment to all individuals with no strengths attached so they can be free from income insecurity. Today their support for this policy is growing in magnitude and diversity as some tech billionaires and labor union activists, socialists and libertarians and US presidential candidates advocate for its implementation. Furthermore recent surveys show that a growing number of people in the US are in favor of a basic income policy as a solution to problems such as poverty, automation, job and income insecurity and gender equality. It is within this context that the self-basic income lab was launched in early 2017 by professor Adriana Bididhanore with the support of the Center for Ethics and Society. The lab aspires to be an academic home for the study of universal basic income. It reviews the vast interdisciplinary research produced on UBI, identifies underexplored research questions and helps shape future directions in basic income research. The lab both guides researchers and experimenters who seek to conduct innovative work on UBI and hire scholars to produce new research. It also convenes key stakeholders and members of the community around the politics, philosophy and economics of basic income and informs policymakers and practitioners about best policies in UBI experimentation. Our lab's website, basicincome.standford.edu has more information about the reset of the lab, current experiments and future events and workshops. Tonight we are fortunate to hear from two distinguished scholars, Evelyn Forger and Manny Browno. Evelyn Forger is an economic professor in the Department of Community Health Sciences at the University of Manitoba and academic director of the Manitoba Research Data Center. She's also an adjunct scientist with the Manitoba Center for Health Policy and a research associate with the MB First Nation Center for Aboriginal Health Research. Forger has extensively, extensively investigated the health impacts of their income, an experimental Canadian guaranteed annual income experiment that was held in Manitoba during the 1970s. Her current research focuses on the health and social consequences of anti-poverty programs and policies and their cost-effectiveness of healthcare interventions. Manny Browno is the associate director of research and senior research scientist at the Manitoba Center for Health Policy. She's also professor in the Department of Community of Sciences in the Max Rady College of Medicine, Rady Faculty of Health Sciences at the University of Manitoba. She is trained as a developmental psychologist and is the recipient of the MCHP Endowed Population-Based Child Health Research Fund. Dr. Browno's research program is centered on the social determinants of health and well-being of children, developing population level indicators of child health and evaluation of programs designed to improve child development and family functioning. Her principal investigations include the evaluation of the province of Manitoba's healthy baby program. We're also very fortunate to have Marcella Alson, who will moderate the discussion. Marcella Alson is an associate professor of medicine at Stanford University and a member of the Health Center for Health Policy. Her research focuses on the relationship between health and socioeconomic disparities with the focus on infectious diseases. The formal of this evening's event is as follows. Professor Browno and Professor Forger, who each speak for about 15 minutes, accompanied by a moderated discussion led by Professor Alson for 30 minutes. After this, we'll open up their floor for questions from the audience. Tonight's discussion will focus on one of the most important challenges of our time, improving people's health and well-being and their access to medical care. We will hear about the impact that cash transfer experiments and programs have had on maternal and child health outcomes as well as mental health in Canada. And we'll learn about the potential effects that unconditional cash policies, such as basic income, could have on health and well-being. Please join me in welcoming tonight's speakers. Thank you very much for that introduction and thanks so much to the Basic Income Lab for inviting me to be part of this conversation. I'm really thrilled to be here. So in terms of unconditional cash impact on health outcomes, I'm going to be talking about a program that's been running in Manitoba for almost two decades, the Healthy Baby Program. A little background on the Healthy Baby Program. It's a government-run program, so it's funded by the government of Manitoba. It started in 2001, and its aims are to improve perinatal and prenatal and perinatal health, and there's actually two components to the Healthy Baby Program. There's community support programs that operate throughout the province, therefore women who are pregnant or parents who have a new baby all the way up to one year of age. The second component of the Healthy Baby Program is the prenatal benefit, and that's what I'm going to be telling you about. This benefit starts in the second trimester of pregnancy, and women who are eligible for the benefit, they receive a check in the mail of approximately $81.41 a month. It's on a sliding scale, but that's the maximum amount, and that roughly translates into about $60 American a month, but they receive that throughout the second and third trimester of pregnancy. To be eligible, they have to be pregnant, so they have to get a medical note confirming the pregnancy, which means they have to make at least one health care visit in their pregnancy. They have to complete an application form, and in that application form, they have to demonstrate that their family income is less than $32,000 a year, and I think that translates roughly into $24,000 American dollars. They have to be a resident of Manitoba, and in order to demonstrate their low income, they have to consent to link to their income tax records, so that they have proof that they actually are eligible for this program. But after that, there's no strings attached, and this makes it kind of a unique program in Canada at least, and when we were doing this study, we looked for other programs in North America, and they are very few and far between. To give you a little background about where this comes from, our research center doesn't run this program. We just did an evaluation of this program, and it was part of a larger program of research called Pathways to Health and Social Equity for Children, or as we called it, PATHS. In PATHS, it was a collaborative research effort. It was funded by the Canadian Institutes of Health Research for actually six years, and by collaborative research effort, what I mean is that it wasn't just scientists within the University of Manitoba, and actually we had colleagues from across Canada and a colleague at Berkeley as well, but it also involved policymakers, people from the government in Manitoba, the Department of Health, the Department of Education, Department of Family Services, people who actually run some of the programs that we evaluated, and community organizations. So even before we got this funding, we got together with this collaborative group and said to the policymakers and the community groups, really, who would be the users of the results of this research, what is it that you want us to look at? What is important for us to be looking at in Manitoba? And they said, you know, there's a lot of programs in Manitoba that are focused on improving the health and other outcomes of kids and their families, but we really don't know if they're working. So we want some evidence that, you know, these programs are working. So we identified actually 12 programs that we evaluated as part of PATHS. The other thing, because the funder was particularly interested in equities, not only did we ask about all these 12 programs, did they work to improve outcomes, but we also said, did they work to decrease the gap? Because we know sometimes programs can work to improve overall health of the population, but at the same time, the gap can increase. The gap between rich and poor can increase. So that really was the focus of PATHS. The way we did all these, whoops, now I've already forgotten how to advance the slides. The way we did all these studies was using repository of data that we hold at the Manitoba Center for Health Policy, and it too is quite unique. There's over 80 different databases in the repository. Some of the key ones are shown on the screen, and many of these are at the population level, meaning that we have information on the whole population. So everybody who has a hospitalization, all the information from their hospitalization is there. When you make a doctor's visit, all that information is there. Prescription drugs are there. A lot of health databases, because we started out as a health policy center, but we also have a number of social databases as well. So all contacts with the justice system, with family services. You can see income assistance up there, which is comparable to welfare. So that information is all together in one place. It is de-identified, meaning we never know who the people are. We don't have their names or addresses, but we do have a unique identifier, a scrambled or de-identified identifier, which if that makes sense, that allows us to link across time and across these sectors at the individual level. Some of the databases go back as far as 40 years. So it really is a really powerful tool for conducting research. So we use this tool to say, okay, is the healthy baby program working? And we looked at a number of perinatal outcomes, low birth weight, small and large for gestational age, preterm birth in five-minute apgar scores. We looked at the length of stay for the birth hospitalization really as a global measure of health at birth. I'm going to knock over my water. And breastfeeding initiation, and you might wonder, well, how is breastfeeding initiation connected to money during pregnancy? And there are some ways it's connected. But one of the main ways we thought was, along with that monthly check comes some information about how to have a healthy baby. One of the things is breastfeeding, you know, the importance of breastfeeding for your baby's health. Beyond the birth period, we looked a little further out at some health outcomes. So we looked at neonatal readmissions. We looked at any hospital admission within two years of birth. And we also looked at immunization rates at one and two years of age, really as a connection to the healthcare system, because that was one of the goals of the healthy baby program. And then even further out, we looked to when kids were entering school. We have something called the Early Development Instrument, which is a teacher assessment of children across five domains of development, physical, social, emotional, language and cognitive development, and then general knowledge and communication skills. And we thought, well, you know, if this is improving outcomes at birth, theoretically it could improve how kids are doing when they enter school. In terms of methods, it's always a little tricky when you're using secondary data, because we didn't plan the study. We didn't plan the intervention. We were asked to evaluate the intervention after it had been running for a number of years. And the trickiest part, at least for me, is saying, who are we going to compare those who receive the healthy baby prenatal benefit to? Because we know that the women who receive the prenatal benefit, they receive it because they're expected to have poor outcomes. So if you just compare those who get it and those who don't, you're going to have an imbalance right away. It's going to be comparing apples to oranges. So for the eight years of data that we studied for this, what we did was we looked at all women during that period who were on income assistance, received income assistance during pregnancy, because we knew they all had an equally low income. And they were all eligible for the healthy baby program. And I don't know if the numbers are showing up well there. I don't know why I put them in a lighter color. But there were almost 11,000 women over that time period who were receiving income assistance during pregnancy and received the prenatal benefit. And then another almost 4,000 who, although they were eligible because they were receiving income assistance, they didn't receive the prenatal benefit during pregnancy. Now, of course, we thought things were tipped in the other direction that now we were comparing oranges to apples because why were those women who were eligible for the prenatal benefit? Why didn't they apply for it? Why didn't they receive it? Maybe they had literacy challenges. Maybe they were suspicious of health care and never made that initial health care visit. And these were things that might affect their outcomes. So we used a lot of information we had from our repository to make sure that the women we were comparing, those who received the prenatal benefit and those who didn't, were balanced in their characteristics. And I'm not going to go into detail. We did what we call fancy math. I'm staring right at Dr. Nathan Nickel, who is a co-investigator in this study. And if anyone needs to know what that fancy math did, Nathan's your man. So I'll jump right into the outcomes. The prenatal outcomes first, the light bar is for those women who received the prenatal benefit during pregnancy, and the dark bar is for those who didn't receive the prenatal benefit during pregnancy. This is after we've balanced women on these characteristics. And what we found, as you can see, it's a quite dramatic difference in the outcomes. Just over 7% of the women who didn't receive the prenatal benefit during pregnancy, their babies were low birth weight, and it dropped down to about 5% for those who received the prenatal benefit during pregnancy. This is for preterm birth. And I will draw your attention to that the scales are going to be different on these. But preterm birth, you can see also a dramatic difference, a statistically significant difference. It was almost 11% for women or for babies of women who didn't receive the prenatal benefit and dropped down to about just over 8% for women who received the benefit. And the provincial average in Manitoba is 7.9%. So that's quite remarkable to get this very high-risk group of women achieving almost the provincial average. This is for breastfeeding initiation. Here, the scale goes to 100%. Not as big a gap between those who received and didn't receive the prenatal benefit, but it is still statistically significant. The provincial average for breastfeeding is about 80%. So here, you can see there wasn't the same sort of catch up to the provincial average. Longer term outcomes, one-year immunization and two-year immunizations, you can see again, statistically significant differences. Quite low immunization rates. Again, it really underscores that these are very women living in very challenged circumstances or families in challenged circumstances. The provincial average is actually around 70%, which is still below the targets of, I think, at two-year. They're targeting about 90% full immunization. Then at kindergarten, as I said, we had a measure of child development across five domains. Only one showed statistically significant differences associated with the healthy baby prenatal benefit, and that was in the language and cognitive domain. In this case, what we're showing the percent is the percent of children who were developmentally vulnerable, which means they scored below the 10th percentile on national norms. About 30% of the kids whose mums received the benefit during pregnancy were developmentally vulnerable on language and cognitive development, and that drops down to about 25% for kids whose mums received the benefit during pregnancy. The provincial average here is 12%. Again, certainly not catching up to the provincial average, but still a statistically significant difference. This slide just really summarizes the statistically significant differences. One I didn't talk about was length of stay for birth hospitalization, but that was statistically significantly lower for babies whose mums received the prenatal benefit by about a quarter of a day, which doesn't sound like a lot, but we know that all adds up over the long run in terms of hospital days. The results of the perinatal outcomes were published in pediatrics a couple years ago. As I said, the other thing that we did, the other question we asked besides is the healthy baby prenatal benefit associated with better outcomes, but is it associated with a reduction in the gap? Here we took a really population level view. We compared women who were not eligible because they weren't low income to women who were low income, not just the women on income assistance, and measured to see, did that gap decrease as a result of the healthy baby or associated with the healthy baby prenatal benefit? We saw statistically significant decrease or measurable decreases in the gap for breastfeeding initiation, low birth weight, and preterm birth. I just want to wrap up. The administrative data and the other data sets we work at the Manitoba Center for Health Policy are wonderful resources for research, a real breadth of data, but one of the things we can't really get at is why is this working? We did a qualitative analysis where we actually asked women who received the prenatal benefit if they thought it was working and why they thought it was working. Really, there were about four main themes that came out that we heard over and over again. The first was exactly the goal of the healthy baby prenatal benefit. Women said that it helped them to eat better during pregnancy to get better nutrition. In this case, this quote, this woman is recognizing, as we all do, that oddly enough junk food is a lot cheaper than healthy foods, fruits and vegetables, healthy foods we know are very expensive. A lot of women talked about the ability to eat better during pregnancy. Secondly, there was a lot of talk about planning for baby, thinking ahead of for baby, things that women bought for their babies, just really thinking and getting excited about the arrival of baby. Really, a third theme was around the reduction in stress by being able to address pressing financial issues. Some women talked about being able to pay the rent every month and not having that stress of wondering whether they were going to be kicked out of their apartment. Again, this might tie in to buying healthy food, but just that reduction of stress of having money to do the things that they felt they needed to do. The final theme was around really caring for themselves and their unborn child. Some women even talked about being able to treat themselves. This quote is about she's always focusing on everything for her other kids, and this allowed her to really focus on something for herself. That's the end of my formal presentation, but I did want to acknowledge this study as well as the whole PAS equity for children was definitely a team effort, and I will pass things over to Evelyn. Thanks very much for inviting me here today. I'm always delighted to talk about basic income. I'm actually going to take you back in time. I should have spoken first because Marnie's very up to date, but I'm going to take you back to the mid 1970s when Canada first experimented with a basic income, and I'm doing that for a couple of reasons. This project in Canada set the stage for a number of benefits we've subsequently introduced in Canada. Based on min-com by and large, we now have a Canada child benefit, which looks very much like the basic income I'm going to tell you about in a minute. We have a similar program for people over age 65, which is again based on some of the principles that came out of min-com. The gap we've got left in Canada are adults of working age, so people between 18 and 64, the politically difficult group to offer a basic income to. The Canada child benefit, I should say, is a basic income essentially for families with children under the age of 18. It pays a maximum of $6,000 a year, which declines as income from other sources increases. Let me start with min-com. Min-com was one of five negative income taxes that were conducted in North America during the 1970s. Four of them were in the U.S., and in Canada we looked at some of the results coming out of the American experiments, and we decided we needed some Canadian data to see what would happen locally. Just to remind you of a few things to keep in mind as I tell you the results of this, the 1970s were very different from the contemporary period. Women were just entering the workforce in large numbers for the first time, so many of the women were working part-time or working a few hours a week. It was a relatively simple income assistance landscape in place. There was an availability of basic income assistance in monetary form, but it was also a time when many social programs were being expanded in Canada, and one of the reasons I was able to conduct this experiment is because in 1971 we introduced universal health care. We have no private health care option in Canada, so the database that Marnie talked to you about actually captures all of the interactions with the health care system in Canada, which makes certain kinds of analysis easy in that context. It was a cost-shared program. 75% of the costs were paid by the federal government, and 25% provincially. It was conducted in the province of Manitoba, and the two main sites were in the city of Winnipeg, which is the only urban center in the province still. At the time it had about 450,000 people living in Winnipeg, and the small town of Dauphin, Manitoba, which was an agriculturally dependent town of about 10,000 people. There were also a few other rural municipalities that were brought in largely to act as controls for Dauphin. Now in Winnipeg, the experiment was designed in sort of a standard way. It was set up as a randomized controlled trial, so the researchers went into town, they selected a small proportion of the total population, and they randomized people into a treatment group which would receive a basic income, and the control group, which would make do with whatever other programs they might be eligible for. Dauphin was a little bit different. It was a saturation site, and it was the only saturation site in any of the basic income experiments, negative income tax experiments of the period. And what that meant was that everybody in town received exactly the same promise from researchers. If you have no income from any other source, we guarantee you a certain level of income. If your income from other sources and in particular from working increases, your benefit declines, but it declines less than proportionately, and when your income gets high enough, it eventually disappears. It's based on family size, so the bigger your family, the more income you had. And the purpose of this experiment, like all of the negative income tax experiments in the 1970s, was essentially to answer the real question that many people had, and that is if you give people a basic income, are people just going to stop working? And this was a real fear, and in particular, there was a fear that young men would stop working. So this whole project was set up to find out if people are inherently lazy, if people will stop working, if you give them money. The payment design was a negative income tax, as I said. The families received money for three years, from 1975 to 1978. The base rate, the promise, was slightly higher than the income assistance they would otherwise have been entitled to. It was called Mother's Allowance, which will give you some idea of how the program was set up at the time. The benefit was taxed back at 50 cents for every dollar earned. And in Winnipeg, it was slightly different. In Winnipeg, they tested a number of different designs, but this was the design that operated in Doven. So what happened to the project? If any of you are old enough to remember the 1970s, you'll remember that this was a time of significant economic upheaval. For those of you who have to remember back to an economic history course you might have taken at some point. This was a period when unemployment was much larger than anybody expected. Inflation in Canada was hitting 12 and 13 percent. Interest rates were peaking out at about 20 percent. People were losing their houses. They weren't able to pay their mortgage. And so the government that began the 1970s very worried about the issues of poverty. By 1975, 1976, they were worried about other economic issues. And it sort of fell off the table. That economic upheaval meant that the provincial government changed in 1976. The first ever social democratic government in Manitoba was replaced by a conservative government. And no government likes to put a lot of money into supporting the special projects of its predecessors. So it lost political support. The federal minority government was sort of hanging on by a thread. And the experiment lost, as I said, lost political support. It continued. The families weren't cut off. People received the money that they were promised. But when the experiment ended, the researchers had no money left to conduct any analysis. So they went back to the government and said, okay, we've collected a tremendous amount of data here. We'd like a few thousand dollars to actually tell you what people said. And they were told to archive the data. And what happened was that 1800 cardboard boxes full of paper data were put into an office in downtown Winnipeg. And two levels of government spent a considerable amount of time and effort arguing about who was going to pay the rent on the office. People sort of lost track of these for a while. The data disappeared. It wasn't entirely clear where it was. And a few years ago, I managed to track it down under the control of the National Archives. There was some research conducted in the 1980s. Some of the people who were involved with the project managed to create a data tape to answer the original question, right? Do people stop working if you give them a basic income? They focused on the Winnipeg sample. And their answer was not really. There wasn't much of a response. Men worked about 1% fewer hours. Women worked about 3% fewer hours. Nothing was very significant. But there were two groups of people who had a much larger reaction. And again, a little bit of historical detail. In the 1970s, mothers were entitled to four weeks of maternity leave. And a lot of mothers thought a four-week parental leave after giving birth was a bit miserly. And understandably, some of them decided to use the income stipend to buy themselves longer parental leaves. So new mothers stayed out of the workforce longer when they received a basic income. And the second group of people who had a larger reaction, and here in the language, is tremendously important. Young unattached males. Young men without a family reduced the number of hours they worked. And they reduced the number of hours they worked a lot by up to about 80%. And that seemed to support all of the stereotypes that people were bringing into this experiment. If we introduce a basic income, the world will fall apart. People will stop working. Well, I had a pretty fair idea of where I might find those young men. So I went looking for them a little while ago. I was interested in seeing if I could get some other results out of this experiment. It wasn't set up to answer health questions. It was set up to answer labor market questions. But I was interested in things like quality of life, investment in human capital, in education, in health, and especially in mental health. And I used some of that wonderful administrative data that Marnie told you about just a minute ago. But I went looking for those young men. And one of the first things I found, these are high school completion rates. Each one of these triples for each year represents the high school completion rates for the town of Dauphin in purple, light purple. Winnipeg is sort of dark purple. And the rest of Manitoba is a cream color. And up to 1974, what you see is about what you'd expect to see. Virtually no difference between Dauphin and the rest of rural Manitoba. And kids who are living in the city are more likely to finish high school. I think kids in the countryside. No big surprise there. 1975, families in Dauphin start receiving money. And look at that purple line for Dauphin. Kids in Dauphin are more likely to finish high school than even kids in Winnipeg. It reaches almost 100% of the kids in grade 11, completed grade 12. 1976, that bar goes above 100% for Dauphin. Kids who'd already left high school and taken jobs were going back to finish high school. 1977 and 1978, families are still receiving money. And that bar is at about 100% for Dauphin. The kids in grade 11 are going on to complete high school, to complete grade 12. 1979, the money stops. And we go right back to where we started from. No difference between Dauphin and the rest of rural Manitoba. And Winnipeg kids are more likely to finish high school. Kid ignored the last set of bars. They built a couple of high schools just outside of Winnipeg and messed up the data. But I was really interested in what the effects were on health and quality of life. And so I used that database that Marnie told you about. And I found matches. I found three matches for everybody who was living in Dauphin, because I knew where people lived. I could find everybody who was living in Dauphin during the period. And I could find three other people who were pretty much like them. Same age, same sex, living in the same kind of family, and living in a similar kind of a town. So I found three to one matches for everybody who was living in Dauphin. And the first thing I looked at were hospitalization rates. Now that blue line represents hospitalization rates for Dauphin. And the red line represents the match controls. So until 1974, people in Dauphin are about 8.5% more likely to be hospitalized than the control group, than other people like them in the province. When the families start receiving money, those two lines start to come together. And by the end of the experiment, there's no significant difference between Dauphin and the rest and their match controls. So what that means is that hospitalization rates fell 8.5% for people living in Dauphin relative to the control group by the end of the experiment. And there was no significant difference. I followed these people up to 1985. There was no significant difference over that period between hospitalization rates. Similar kind of pattern for length of stay. When I looked more closely at the codes to find out why people were less likely to be hospitalized, there were two things that popped up as particularly significant. There were fewer accident and injury hospitalizations. Accident and injury hospitalizations is a huge code and it's picking up almost all acute hospitalizations. And that's always associated with poverty. So there's no big surprise there. From my perspective, the particularly interesting result is that there were many fewer hospitalizations due to mental health issues associated with mental health outcomes. I looked at physician contacts, visits to family doctors, and I found the same kind of a pattern for visits to family doctors. Here the only thing that showed up as statistically significant were visits to family doctors with mental health complaints. So people were less likely to go to their family doctor complaining of depression, complaining of anxiety, and so on. I also looked at birth outcomes. I'll mention that since Marnie already talked to you. I didn't find anything statistically significant. I think my sample size was too small. You think of a town of 10,000 people, but 10,000 people don't actually produce that many babies over a three-year period. And the babies they do produce are by and large healthy. So poor birth outcomes are fairly rare in that group. So kids may have been the most affected overall. They tended to stay in school longer. That meant they got married later. They had their first child later. They had fewer kids over a lifetime. I gained relative to match control groups. All of those things are associated with better outcomes for both the kids and the parents. And those results were used to design another experiment that was introduced in Ontario in 2017. Ontario had a very ambitious plan to run a three-year basic income experiment to update the results that we found for Dauphin and Winnipeg. And again, in very good Canadian fashion, they took another lesson from Mencom, and they changed governments midway through. So the experiment was introduced in 2017. By 2018, the new government decided to cancel the experiment. So there's no actual statistical data that came out of this except for the baseline survey. But the experiment was cancelled in a particularly callous way. The minister announced to the press in July that the experiment would end and details would come later. There was no communication with any of the participants in the experiment. Two months later, the minister said that because they were a compassionate government, they would slowly wean people off this so they get to keep the money for a little while. But the participants in the experiment for two months had no idea what was going to happen to them. They didn't know if they were going to receive money, how much money they were going to get, whether they would be transitioned to other programs or anything else. So one of the things that happened was a number of people sort of reached out and they shared the results of what this meant to them. And so I want to leave you with a couple of pieces of email that people sent to me. And I'm sharing this with the permission of the people who sent it to me. So my question is, what happens to health when a basic income experiment ends? And in particular, what happened during the 30 days of uncertainty before the clarification of the status of the participants? And when I read these to you, I guess the thing I want you to notice is how articulate people are and how well they understand exactly what's happening to them. Again, this email is being shared with the permission of the people who sent it to me. This is from a woman in one of the northern sites in the experiment in a resource dependent town in northern Ontario. She says, I was not surprised so many of the disabled ones were like me, survivors of child sexual abuse with chronic health problems and lifelong mental health and addiction addiction problems. Being in the pilot worked so beautifully for those of us with high ASIS scores, ASIS scores or adverse childhood experience scores. So the higher your score, the more bad things happened to you as a young child. And of course, it does. We never had any security. And to get it, some of us for the first time and leashes are potential in a million ways. This is another woman writing from Hamilton, an urban centre. I wanted you to know you when she meant proponents of basic income, not me personally, made us feel like we mattered. The words of the state who were harmed in child welfare, who were never helped by medicine, who have been ostracized over and over and over. I want to say there's a special place in my heart for those in the pilot whose trauma was grossly misdiagnosed to psychotic illness by a mental health system. This is another different another woman. In fact, I'm having bandwidth problems due to the trauma that makes some of my other trauma symptoms flare up sort of migraines that went away in the pilot are worse than ever. They started coming back after the election, though, I could see the handwriting on the wall. So I guess I just want to leave you with one question. And that is that I really do think it's all about the kind of society we want to build. I think when we think about how it is, we convince people that we want to introduce a basic income. Many of us, and I'm particularly guilty of this because I'm an economist, I think we want to look at outcomes and we want to talk about the financial returns, the fiscal response to a basic income, or we want to talk about the health benefits. We want to talk about particular things, but it really is all about justice. I think it really is about social justice. Thank you. Thank you both for those really phenomenal presentations. So I am also an economist by training as well as a physician. And I think I work a little bit in development economics as well. And some of the most popular programs for improving child health in developing countries have been conditional cash transfers. And so this is for those who might not be very familiar with these programs. Things like Progreso are now known as Opportunidades. Might even have a new name now in Mexico, which was sort of the flagship example of these programs whereby parents would receive transfers if their children were taken to the doctors for certain visits and also educational outcomes were attained. So I was just wondering in your experience, Marnie, how you kind of trade off a more or well less conditional transfer with sort of a very conditioned transfer and what you think about that trade off. Yeah, it's interesting because in Manitoba, before the healthy baby prenatal benefit came into being, there was a program before called I think it was women infants, it's not WIC, but WIN, Women Infants and Nutrition. And it was similar because there was a cash benefit and there was community support programs. But women had to go to the community support programs to get the benefit. Again, when the government changed, so government changes do so many things, but the new government was a little more left of center than the original government and they said, you know what, we're going to drop that condition. I actually don't know what the thinking behind that was. It was just a progressive decision on the part of the minister of health at the time. And as part of our qualitative study, we went back because I was around in 2001, well, of course I was, but I remember reading about and hearing that people said, oh, you can't do that. And so we went looking for some quotes from the time and we actually went into the, there's a record of the legislature, I don't know, I suppose you don't have that in the US called the Hansard, where everything that people say in debate comes up and the opposition, and we actually were able to pull up a quote that said that the new government, they didn't say the new government, they said the government has its head in the sand if they think they can give poor women money without having conditions or accountability. So, and yet, you know, our research demonstrates that the outcomes were, at least it looks like, the outcomes, it was definitely associated with better outcomes. And so, you know, in terms of that tradeoff between whether you have conditions or not, I think one of the important things, and this also came up in our qualitative study, was that women felt trusted to do what they wanted with the money. And I think very often we don't trust poor people to make good decisions from that quote, you could really see that, you know, they even said that in the legislature. So, I think that tradeoff, the unconditional benefit, you know, gives that sense of, you know, this is my money to do what I want with, and I can decide what's good for my baby. So, that sort of the theme that was coming up with Evelyn's work of sort of psychological well-being, fungibility, a sense of control kind of coming up over and over, because again, as economists we know that you can incentivize people to do things, but are they really buying into it as well, which might be something different? Well, there was an interesting study done in Malawi, a three-armed study, a condition, some villages received a conditional cash transfer, some received an unconditional cash transfer, and then there was a control group of villages. And the purpose of the experiment was to convince families to send their daughters to school. And no big surprise here, the families that got the conditional cash transfer, that is they got the money only if they sent their daughters to school, their daughters went to school, right, it worked better. But there was subsequent work done, and they found that HIV transmission rates were lower in the unconditional cash transfer. And so people, that wasn't the purpose of the study, it was a secondary analysis, and so people are asking, Malawi has a high HIV prevalence, why would the rates be lower? Well, it turns out in the conditional cash transfer, the poorest and most marginalized families still didn't send their daughters to school, which meant that they were not part of the experiment, they didn't receive any money. They just withdrew. The cash transfer wasn't enough to convince their daughters to send their kids to school because they still faced transportation problems, the daughters might have had other uniform responsibilities and so on. With the unconditional cash transfer, the girls were less likely to go to school, but the additional money to the family meant that there was a lot less transactional sex work, which was the vector for HIV transmission. So, I mean, if you buy into the fact that families might know better than the experts what the most important developmental goals are, you might make the argument that the unconditional cash transfer had a pretty positive effect. It didn't have the effect of convincing them to send their daughters to school necessarily, at least they did better than the control group, but not as well as the conditional cash transfer. But the families did put the money into very good use. Right. Right. No, that's, that's, it's a very sort of paternalistic view of we know what should be incentivized and if you do this, you'll get the money and you won't otherwise. The other thing that people talk about in terms of conditional cash transfers are that they might have some administrative overhead that is now for the experiment in Manitoba for the babies. I guess they did have to confirm in some way that the women were pregnant. They needed to confirm in some way, maybe in Winnipeg, that they had some income requirement. Right. I guess in Dauphin, they just, they just gave it to everyone. Is that right? No, it was conditional on the amount of money that families had. So, they had to check the income. And was that onerous or maybe not so much in a place like Canada where your administrative records are already very good. And the envy of everyone that works in the US. It would be easy now. It was actually onerous enough at the time because people had to actually send in their pay stubs in order to do it. I see. And in terms of the prenatal benefit, I mean an advantage in Canada is there is no cost for healthcare. So it didn't, it shouldn't have cost women to get that medical note. We did hear anecdotally though that there were some doctors in the inner city who were charging women to get the note. Oh goodness. Yeah, oh goodness. Because they are allowed to charge for what are considered, you know, additional services not covered under Medicare. So it happened, unfortunately. Yes, very much so. And do you have any thoughts about how something would translate in a setting where there is not universal health insurance? Yeah. But there is, I mean there are some programs, right? Like, you know, there's things like welfare. And so there are mechanisms to get people living in, you know, poor people living in challenging circumstances, additional supports or income. So I think a program like Healthy Baby could be put together in the United States. It may just be more difficult because the, you know, charging women to go to the doctor would be a great barrier to getting this off the ground. So putting on my economist hat again, thinking about unintended consequences of these programs. So one of the things that comes up is even as light touch as it is, conditioning on proving you're pregnant might encourage more pregnancies, might encourage people to earn just a little bit less so that they can, you know, be right under the threshold for eligibility for some of these programs might lead into migration and to some of the communities that are receiving the program versus communities that aren't so generous. What are your thoughts about those concerns? I mean, I think they're at least reasonable on paper and probably require some thought. I think the migration issue is an important one. It was solved in the case of DoF and by ensuring that people had lived in the town for six months before the experiment was introduced. So for the experimental purposes, people weren't moving there in order to benefit, but I do think that that's an issue if you have a municipally based basic income. I think certainly it's easier to think about doing it at the national or provincial or state level than a municipality. The labor market incentives I think are overblown. I think economists focus on the labor market incentives to an incredible extent because we think about labor all the time and we assume that people are making these decisions on the basis of their marginal tax rate. Three of us are in the same department and I'm willing to bet that what do you think five percent of the people in our department could tell you what marginal tax rate they're paying? Maybe? I just don't think that people are making those kinds of decisions. If you think about a negative income tax, the way it's designed, it disappears very, very gradually and so ensuring that you're just eligible for it is not going to get you very much money. You'd have to virtually go from being full-time unemployed to making nothing at all in order for it to have a huge impact and I just don't believe that that has that kind of an impact and we didn't see it in any of the results. Is it something that might be graduated such that and this is all about calibrating the amount of the subsidy and it's overly generous and you can in fact. The level and the tax back rate are all going to change the incentives to some extent and I think one of the reasons they tried out several different arrangements in the city of Winnipeg was in fact test the labor market incentives. So again great that there is a basic income lab to experiment with all of these things and in terms of just fertility responses and maybe nothing much. You know that's something we didn't even consider that this $81.41 a month might actually increase fertility rates but it's somebody asked me about it last night and I thought huh I never even thought of that. I really I have to agree with Evelyn I can't imagine that that would be an incentive. I think we do have some some a date on that from the candidate child benefit there's certainly no evidence that women are having more babies to get $6,000 a year. Yeah and it's a lot it's a lot more generous than the healthy baby and the women by the way going back to the labor market incentives the initial results seem to show that women are working more with the child benefit because they're using it to pay for daycare. That's really interesting and so and speaking of daycare or nutrition what about in-kind transfers kind of another kind of direct maybe paternalistic way but why don't we just do universal preschool and you know snap cards for everyone and things like that. I like the idea of universal preschool and why not have universal housing you know everybody who needs a house gets a house so I suppose if we had programs like that in place we wouldn't need basic income or not as much basic income but I'll let the economist speak to that. I actually am a big believer in universal programs like daycare and like healthcare housing is another one in tight housing markets I think you do need to do something more than just the basic income to ensure that people have access to housing. Snap is something that just makes me crazy if people have incomes high enough you don't you don't need to give them money so that they feed themselves. I mean people know that they need to eat and they they can feed their families they can make those decisions for themselves. I think unless there are unless you have good evidence that providing the service directly is going to be more efficient as we do in the case of health care for example it's simply more efficient to provide universal health care than it is to provide it through the market you can make similar kinds of arguments I think for daycare but unless you can make those kinds of arguments give people money. I guess that's so one of the neat features of universal basic incomes unlike a negative income tax it wouldn't necessarily gradually dissipate as your income increases it would be the same no matter what. I guess the last question I'll ask and then I'll open it up to to the audience to comment you know another thing about universal basic incomes that it's supposed to be guaranteed and given that both of you kind of mentioned the politics behind whether or not these programs actually get off the ground and and you know what are your thoughts on how people can build their expectations on these programs have faith that the money will actually be provided and you know that it can really deliver on the promise of alleviating you know psychological stress and whatnot if it's so tenuously related to political whims and things like that. I think experiments are very tenuous I don't think that's the same with policies I think any government in Canada who tried to eliminate the Canada Child Benefit would be a very short-lived government I think if you have a policy in place what is that benefit I'm sorry the Canada Child Benefit is $6,000 a year per child it's a very popular program. I can't imagine. It's income dependent but I think it's much harder to take away a program now we've certainly seen programs being chipped away over time and transformed over time so I don't think I don't think that there's any magic potion that protects a basic income from the kind of political attacks that we've seen other programs come under but I don't think that a basic income program would be subject to the same kind of volatility and capricious decision making that the experiments were experiments are you know they don't they don't affect a lot of people in the larger scheme of things and it's easy to use them to make political points. And I think with that with the Healthy Baby it's a little different because it's not a universal program it's a targeted program so it seems to me unfortunately there would be less of an uproar if it was pulled. It seems to me those people who sometimes don't have a strong voice or aren't heard as strongly are those who are receiving it. The thing I'll say about the Healthy Baby program that $81.41 a month when the program was introduced in 2001 it was $81.41 a month in 2019 the maximum is still $81.41 a month so we've actually done some time trend analysis that we haven't haven't published yet but it does show that there's a decreasing benefit of the benefit that it's no longer making a difference so sad. Well with that I'd like to open it up for questions. Hello can you guys hear me? Thanks for a great talk. My question is whether there was any consideration for adjustment of amount of cash based on demographic features or anything like that in consideration of wealth disparities because while income disparities may be you know 60% 80% wealth disparities are an order of magnitude and given that you know $84 and however many cents a month is unlikely to cover an emergency room or even the ambulance to the emergency room did what was there any consideration to up the amount in certain demographic groups that may be disadvantaged on a wealth basis? It actually is a sliding scale the Healthy Baby prenatal benefit so as I mentioned the the cutoff is $32,000 and family income below that gets the Healthy Baby benefit if you're around $32,000 your benefit is about $10 a month and so much many fewer people apply for that. The women that we studied were all receiving income assistance so they got the maximum benefit because their average income was about $9,000 a year that's Canadian so you know it's slower in America and plus thankfully we don't have to pay for emergency visits and ambulances but you know there's a lot of things that even taking your kids to the doctor doesn't cost you but it costs you to get there or it costs you to pay for a babysitter to look after the other kids while you take the sick sick baby to the hospital or to the doctor. I think your question was about wealth disparities primarily. I think in neither case was wealth taken into account. It was solely on the basis of income. And I would venture to say that the women receiving the maximum benefit don't have a lot of wealth. The income isn't giving them wealth it's giving them enough to spend that month. Hi. Hi. Well let's see. They'll have so many questions and I can't ask them all because I would be taking over this time. Did you compare culture or was there a cultural differential in the families that you looked at? Number one. Number two, was there any pride in those families in the way they accepted or didn't accept the help? And number three, it's absurd to give $84 a month and then expect to have a response, a reasonable response from from the people undertaking this program. So I'll answer that one first because I'll tend to forget but that first this was a 10% increase in monthly income for these women. So you know and I'll tell you we said the very same thing when we started this we said are you kidding me? But I think we don't recognize how poor the very poor are and what they're living with and what they're expected to do with very very small amounts of money. And so I don't think it's unrealistic to say that $81.41 a month actually helped them to reduce that stress to buy a little extra food. I think it really did have an impact. I know you had asked about cultural and in Manitoba we have a relatively high indigenous population and indigenous First Nations Métis and Inuit and in Manitoba it's predominantly First Nations and Métis. We didn't separate them out in in this analysis but we have since since we did that this study we're partnering with First Nations group and First Nations researchers to focus on First Nations kids and look at their outcomes and separately we're partnering with Métis groups to look at Métis kids. I can tell you the results are very similar. I can't remember your third question I'm sorry. Okay I have another question I'm sorry. Did any of these people have grow their own food or raise their own food or you know in some way? Yeah and that's you know with with secondary data that's not something that's collected in most administrative data sets but would be you know sort of interesting to to look at. One thing I'll say I mean it's throughout the province this benefit and food costs very like food costs range so much across the province and it's an amazing thing that in Canada liquor the price of liquor is regulated all over so if you you know a $10 bottle of wine is a $10 bottle of wine all over the place milk you know it's it's through the roof fresh fruits and vegetables people living in the north it's unbelievable what they have to pay so the geographic variation we did find that preterm birth in in the in the rural areas didn't decrease as much as in the urban areas and so we wondered if that had to do with the the cost of food. Sorry everyone. Hi first of all awesome presentations and thank you for coming. Second my question is for Evelyn. I appreciate that you were investigating what what about these statistically significant unattached males that data is worth reexamining and you said that a portion of that could be explained as a result of these males who already graduated school coming back and saying you know what I didn't really give high school the my all so let me come get my education and do right this time but what about the rest were they just lazy? Actually I should have explained that a little bit better I you know when I started when I started doing this project I had to get ethics approval and one of the constraints that the ethics board put on me was that the researchers in the 1970s hadn't collected waivers from the families allowing re-contact and so I wasn't allowed to contact them well no one did that in the 70s but I wasn't allowed to contact them but fortunately Manitoba and especially Dauphin's a pretty small place and so when I when word got out that I was working on this project a lot of people called me and talked to me about their experiences and the experiences of their neighbors and friends and so on and I knew what was happening and sure enough it was confirmed by the people who participated a lot of the kids in low-income families especially the boys when their family before income came along they were under a lot of family pressure to become self-supporting as quickly as they could so legally they could leave school at age 16 and if you're a 16-year-old farm boy who's used to tossing bales of hay around there are lots of jobs you can get that pay pretty well given you know if your expectations are low enough these jobs pay well if for for good strong boys and so they were essentially encouraged to get out and get a job as quickly as they could when min-come came along a lot of those families thought well you know we can we can afford to support this kid in school for another year and it was primarily boys right we can afford to support him in school for another year and whether the boys decided that they wanted to stay and study math or they just wanted to hang around and play football I don't really know what the answers were but they stayed in school for another year and I think one of the from to me that's probably the most telling finding because if you think about the differences in life opportunities that are available to somebody who graduated from high school in the mid 1970s and compare that to the personal left school at age 16 and you know what kind of jobs they got they got jobs in farming well you know farming used to employ like 40 percent of the workforce and right now it's about two percent or they got jobs in and manufacturing well manufacturing jobs have virtually disappeared over the last 40 years so those kids at left school at age 14 sure they got great jobs when they were 16 years old hard jobs hard physical jobs and over the years they would have experienced belts of unemployment and lower wages the kids who managed to finish high school I run into them all the time when I go to Ottawa and talk or when I go to Toronto and talk because they went off to university and they got jobs somewhere else and their lives are very different so yeah it's not just the kids who came back to school it's it's it's that entire cohort of low income primarily boys it didn't have the same effect on girls because girls didn't have the same opportunities in the labor force so if they were 16 years old unless they were you know leaving to marry their slightly older boyfriends they probably stayed in school until they until they graduated but the boys were leaving school early to support themselves to become independent and we saw the same thing I should say again it's only anecdotal evidence but we saw the same thing happening in Ontario with that experiment the first thing that many people did was to take the money they received from the Ontario experiment register for community college not high school anymore but now we're talking about job training and community college thank you so much I was just curious for any of the factors which were looked at as far as outcomes you know there's current government spending and I'm not as familiar with Canada by any stretch but certainly through different departments different agencies with different missions that impact many of the different strata that we're looking at here and there's a certain dollar per outcome ratio that tends to be cited year after year and tracked fairly rigorously but has that ever been compared to the outcome seen here because hypothetically I mean should this actually pencil out better at reducing you know whatever it is or increasing that I mean there's imminent streams or very large streams that could be imminently used politically successfully to fund something different do you want to answer that well you know I'll start because you'll have a better answer but with our with our you know I talk about it like the healthy baby program is our program but with the healthy baby we've we've done some sort of back of the envelope calculations for particularly when we did the report initially for government but really just looking at very short-term outcomes so as I said you know the length of birth hospitalization stay reduced by a quarter of a day so we calculated that out we calculated you know what a preterm birth cost compared to to one that was at term and and did some not very fancy math and there it was there was some savings there weren't huge there weren't huge savings but there was some savings with the healthy baby but that was just the you know the very the birth outcomes we never went any farther and it gets really quite complex to be able to say okay this is a result of the healthy baby because there's so many intervening factors and particularly when you start looking at the costs and benefits so you know we've just been looking for a good economist to work with us to to to find if Evelyn wasn't so busy with it I can I can I can again back of the envelope calculations if you if you believe my findings that health care costs declined by about eight and a half percent below what the otherwise would be Canada spends about 250 billion dollars a year providing health care when Ontario cancelled when Ontario introduced its project there was a considerable discussion in the among politicians and one of the opposition politicians asked the parliamentary budget officer what it would cause to introduce an Ontario style basic income across the whole country and parliamentary budget officers like the congressional budget office and he calculated that it will cost about 23 billion dollars to offer this program across Canada to all Canadians so eight and a half percent of 250 billion is what 20 22 billion something like that 23 billion is what it would cost to introduce the basic income so the healthcare findings in a country like Canada where we've got socialized medicine we're paying we're paying incredible amounts of money in the healthcare system in Canada to treat the consequences of poverty when you walk up and down the hallways in the hospital and you see 35 year old people who've had legs amputated you know it's a secondary effect of diabetes when you're when you're seeing people being hospitalized because chronic conditions are being exacerbated people are in the hospital because they've spent years and years and years living in substandard housing and dealing with the consequences of of of discrimination in the labour force and living with poor diets and living with all of the things that accompany poverty and we've got no choice but to treat it and we treat it in the healthcare system that's a really inefficient way to be spending healthcare dollars if you can take those dollars and give it to families up front so that they can take care of themselves and take care of their families and access reasonable diets and reasonable housing it ultimately is going to pay for itself there are for sure some upfront costs to offering this program 23 billion dollars according to the parliamentary budget office but look at the long-term returns on this and I'm only talking about health because Marnie's marvelous database is primarily a health database think about the savings in terms of special education right how much money do we spend every year teaching reading recovery programs and special education to kids who need these programs because their parents move all the time because they can't afford to pay their rent and they're going from school to school or kids who end up in the youth justice system or end up in the child welfare system because because they've got case workers who can't tell the difference between poverty and neglect these are incredibly expensive costs associated with poverty so the answer is no nobody's done a simple cost benefit because it's too hard to do that but it doesn't take a whole lot to realize that the returns are are pretty pretty strong I guess this wasn't really a health care related issue directly but was there any analysis of the difference in crime rates in the communities that received the income sorry crime rates crime rate oh in in my case no because I was focused on on a little town and rural crime is is is weird it's it's very spiky so it's hard to do that to do that kind of analysis um that was one of the things we were hoping to do at the Ontario experiment I will say that uh in our wonderful database though we do we are able to to look at those who have contact with the justice system and and what their sentencing is and then incarceration rates so Evelyn will be able to do that in future going forward not backwards and we're doing it with some of our other evaluations that we did as part of our PAWS program of research too I have a quick question how do you view um because I view with a little bit of skepticism the notion that and this is kind of heretical here in Silicon Valley but the the the tech giants and you know the Elon Musk's and the Marx of River they're they're they're they're heavy embrace of of UBI has me a little bit worried obviously they're thinking about automation and and and you know thinking forward to people being disengaged from the labor force and needing to have something to to um to buoy them in those times in those lean times um but I guess on the flip side you know there is this concern that it will crowd out in kind transfers it'll crowd out at least in the setting of the U.S. EITC and SNAP and WIC and all the other transfer programs that we currently have as meager as they are compared to Canada um and and there isn't as much discussion or proselytizing about you know about strengthening those programs alongside of it of a UBI it it often tends to kind of come to an either or given that where you have limited budgets and limited political will to to help the needy at least in in our kind of puritanical bootstrap culture of you the United States so just wondering if you have any thoughts on on those sorts of tradeoffs and I'll let the economist answer this one I have you had those conversations in in Canada yeah yeah there's a there is a every program has its advocates right and there is a real fear that among many people that if the energy is going into it and to advocating for basic income what does that mean what does that mean for health care for example if we're putting more money into basic income it's got to come from somewhere and provincial governments in Canada are responsible for both income assistance and health care um you know so there's those kinds of theories have been expressed um the take your math seriously you can say it's budget neutral but yeah revenue but in the short run yeah right right right the budget's gonna come from some way considerations right um I um those this those discussions have happened in Canada certainly I don't think that there are very many advocates of a basic income in Canada who are arguing for the elimination of other general social programs so the conversation is mostly basic income and basic income and health care basic income and child care basic income and other kinds of things but the fear is there for sure and I do think that I do think that we need to be rethinking all of the social programs that we offer we have an incredible mix and you have an even bigger range an even bigger range of programs offered by many different levels of government and some of them make sense and some of them don't make sense and I think that I think that one of the things that we have to do going forward is to think about how to bring some of these programs together when the parliamentary budget officer costed this the first question he asked was well which of the tax credits are we gonna roll into a basic income so some of them did get rolled in and I think the right decisions were made but I'm not sure that that judgment is universal good question we we've actually discussed with the healthy baby knowing that the the benefit has decreased I mean one of the one of our quandaries and obviously we will publish this but our worry is that you know the government may look at that and rather than say hey let's increase the healthy baby prenatal benefit they'll say well if it's not effective anymore we'll get rid of it and so a number of us have been discussing some way of doing an actual experiment where some women will continue to get the benefit as it is now and randomly assign some to get more and you know sort of have I don't know if you can say definitive evidence but some stronger evidence that it's actually the benefit that's that's leading to the to the benefits that we're seeing so if you want to fund that what's in the future for you I wonder if you could get at that in another way I don't know if within that province there's like huge differences in cost of living or something like that so that you could say look in these areas where cost of living is not so great it's still having you know you can see if it's still having a big effect and then in places where the cost of living is going up or whatever the PPP whatever the purchasing power or something like that is real is like not as great maybe the benefits are not as not as robust anymore so you can get at that in other ways so that it's not just like oh the benefits not working but like where is it working and how are those places different as I said you know we did have the difference in the in the preterm birth results um rural versus urban but it was a pretty gross cut right like we didn't get down to to sort of micro economies I don't know if that's what you'd call them within manitoba but it would be another way of looking at it and it looks like my colleague wants to cost a leader a leader or gallon whatever you call it here a quart a quart of milk you're so Canadian now Nathan oh maybe you don't want it to so like this is the discussion though about the change in the benefit like just literally sitting here the question has been coming into my mind of and it's an economist question so I'm really sorry about this if we do a basic income and we raise like income levels like has there been work to identify whether or not that will impact inflation or impact cost of living and then we're still in the same situation as we were before negative income tax in fact all forms of basic income are not about increasing the amount of money and circulation they're always redistributive right so you're taking away from people like you whose income is too high so you see you so yeah so you're putting money in the bank and you're saving it and you're giving it to low-income mothers who probably are going to spend it on new running shoes for their kids or or food at the local shop so yeah would have some effects on local economies it might you know the the corner cafe may raise the price of coffee but it's not going to have an overall and they have found that so at least in the United States and like first of the month 15th of the month when snap benefits grocery stores do raise prices on the poor which sort of like the doctors you know charging to fill out these forms it seems really I mean it would be something to watch for I think yeah for sure hi I'm not sure about Canada but in the United States one of our most regressive taxes is the payroll tax for historical reasons it's thought of as a way to fund social security and that means it falls almost entirely on the lower income earners and one of the things that got us out of the economic crisis was a form of payroll tax subsidy called the making work pay I can't remember what the exact name was but it was a it was like a per paycheck in earned income tax credit where everybody was paying less on their deductions and this is a completely different because it takes money away from people who are making a lot of money gives it to the people who are working and is definitely extremely conditional on on going out and earning money but it's got the incentive that escapes the criticism that's a lot of the unconditional transfers and basic income have so I wonder if you what's the Canadian perspective on payroll tax do you charge money to put someone else to work and if so does it help to charge less yeah we've got the same kinds of crappy taxes in Canada that you have I think one of the one of the interesting things that's come out of the basic income debate in Canada is that there is a very large appetite brewing for overall tax reform for a large royal commission on taxes in general so yeah I think that that's that's certainly one one way of helping people out eliminating some of these progressive um inefficient taxes question for Marnie and for whoever helped with the fancy math which is um and I'm using judgmental language for the purpose of just proving my point not because I actually feel this way but um it can you talk more about how you controlled for the fact that women who qualify for the benefit but didn't ever bother applying for it to just don't care about their babies as much and therefore wouldn't would be expected to have worse health outcomes yeah I don't know whether we can say that they don't care about their babies that much and I know you said you know you qualified your question um I can say that you know there were a number of characteristics we were able to look at for both and I can't remember if I gave you some examples but things like whether mom smoked during pregnancy whether mom drank during pregnancy mom's education level um we we didn't have yeah that's yeah so there's universal screening a variety of questions and stuff like so not but it does ask things like about the maternal social isolation upon the social isolation history uh maternal trauma so is the mom the use of the child uh substance use uh during pregnancy so uh with mom and the father and one of these like so on those factors what was interesting is like who was more risky than not and in some cases actually the recipients were had higher risk profiles so to speak than the non-recipients yeah in fact I was I just looked it up before this there were six things I think there was a probably 25 risk factors we looked at or characteristics to balance the groups and there were six that that really differed the rest were we really didn't need the fancy math even though we used it and of those six five of them the recipients were worse off than than you know so they were more likely to have histories of child abuse and they were more likely to have mental disorders and um I can't remember what the other ones were but they um it wasn't that the the women who were eligible and didn't apply for it were worse off than those so we again with secondary data we really don't know why those women didn't apply maybe you know it was too much trouble to to do this for 81 dollars a month um well that's right so we um when we were interviewing the moms we had some moms who they had received benefit this time but they didn't with the last child of it and it came up actually that like I was traveling back and forth from the reserve and uh to my doctor's appointment which is too much going on um so I just wasn't able to get together one of the moms was talking about actually a friend of hers it was it was really interesting she said oh she's just being lazy for not applying for this wonderful benefit and and then she keeps talking and by the end of the conversation she's like well actually she has three kids already and she's having to work two jobs and so she's probably just too busy to and you see that transition in in in recognition just even during the course of a couple of minutes of dialogue with that with that mom talking about her friends so yeah there's a lot happening in these families lives um I'm gonna stop us there um just cognizant of our time but I want to thank you guys so much again for coming and um for presenting to all of you who attended thank you for coming out tonight feel free to visit our webpage basicincome.stanford.edu for more events in the fall and we'd love to see you there thank you again for coming tonight