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The Town with No Poverty: The Health Effects of a Canadian Guaranteed Annual Income Field Experiment

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This paper has two purposes. First, it documents the historical context of MINCOME, a Canadian guaranteed annual income field experiment (1974 to 1979). Second, it uses routinely collected health administration data and a quasi-experimental design to document an 8.5 percent reduction in the hospitalization rate for participants relative to controls, particularly for accidents and injuries and mental health. We also found that participant contacts with physicians declined, especially for mental health, and that more adolescents continued into grade 12. We found no increase in fertility, family dissolution rates, or improved birth outcomes. We conclude that a relatively modest GAI can improve population health, suggesting significant health system savings.
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Commentary/Commentaire
The Town with No Poverty:
The Health Effects of a Canadian
Guaranteed Annual Income Field
Experiment
evelyn l. Forget
Community Health Sciences
University of Manitoba, Winnipeg
L’objet de cet article est double. Premièrement, il documente le contexte historique du MINCOME, une
expérience canadienne en matière de revenu annuel minimum garanti réalisée de 1974 à 1979. Deuxième
ment, grâce à des données provenant de dossiers de santé administratifs et à l’utilisation d’un modèle quasi
expérimental, il indique que le taux d’hospitalisations chez les participants à cette expérience était de 8,5 %
inférieur à celui d’un groupe témoin, et que cette différence était marquée surtout dans les cas d’accidents
et blessures et de maladies mentales. Les résultats montrent aussi que, pendant l’expérience, les visites des
participants chez le médecin, en particulier pour des questions de santé mentale, ont diminué et que plus
d’adolescents ont poursuivi leurs études après la 12e année. Par ailleurs, les résultats n’indiquent aucune
hausse du taux de natalité et du taux d’éclatement des familles, ni d’amélioration en matière d’issues de la
grossesse. Je conclus qu’un revenu annuel garanti même modeste peut permettre d’améliorer la santé d’une
population, entraînant ainsi des économies importantes pour le système de santé.
Mots clés : revenu annuel minimum garanti, dossiers administratifs, impôt négatif sur le revenu, résultats
pour la santé, revenu de base, MINCOME, expérience sur le terrain
This paper has two purposes. First, it documents the historical context of MINCOME, a Canadian guaranteed
annual income field experiment (1974 to 1979). Second, it uses routinely collected health administration
data and a quasiexperimental design to document an 8.5 percent reduction in the hospitalization rate for
participants relative to controls, particularly for accidents and injuries and mental health. We also found
that participant contacts with physicians declined, especially for mental health, and that more adolescents
continued into grade 12. We found no increase in fertility, family dissolution rates, or improved birth out
comes. We conclude that a relatively modest GAI can improve population health, suggesting significant
health system savings.
Keywords: guaranteed annual income, administrative data, negative income tax, health outcomes, basic income,
MINCOME, eld experiment
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introduCtion
The idea of a Guaranteed Annual Income (GAI)
is once again receiving attention from policy
makers and decisionmakers at local, provincial,
and national levels. In from the Margins, a report
of the Standing Senate Committee on Social Affairs
(December 2009), made several recommendations
for addressing poverty with a GAI. The idea of a
GAI for people with disabilities was picked up by
a House of Commons committee studying poverty,
and in Quebec a government task force went fur
ther, recommending a minimum guaranteed income
starting at $12,000 for everyone in the province, a
proposal that remains controversial.
1
One context in which a GAI is attracting par
ticular attention is among those charged with
responsibility for public health.
2
It is wellknown
that poverty is one of the best correlates of poor
health (Feeny et al. 2010; Marmot and Bell 2009;
Marmot, Allen, and Goldblatt 2010; Morris et al.
2007; Pickett and Wilkinson 2009; Raphael 2007;
Victorina and Gauthier 2009; Dahlgren and White
head 1991; Evans and Stoddart 1994; Marmot and
Wilkinson 1999; CSDH 2008). It seems reasonable
to ask whether a GAI, by reducing the prevalence
of poverty in the community, might lead to better
health outcomes and help to restrain the growing
costs of treating poor health.
Canada has had a long flirtation with the idea of a
GAI. Between 1968 and 1980, five field experiments
were conducted in North America, primarily to in
vestigate the impact of a GAI on the labour market.
One of these experiments, MINCOME, was con
ducted in the province of Manitoba between 1974
and 1979 and had the distinction of being the only
experiment to include a saturation site—the small
town of Dauphin, Manitoba—in which everyone was
entitled to participate in the experiment. For reasons
discussed below, MINCOME ended without much
analysis or a final report. This essay reports on our
attempt to use routinely collected health administra
tion data to determine what impact MINCOME may
have had on population health.
the Culture oF the Period: guaranteed
annual inCome i n ameriCa
Canadian interest in a GAI during the 1970s paral
lelled American investigation of the idea. In the
United States, the civil rights movement of the 1960s
brought home to ordinary Americans the persistence
of poverty despite the growth and prosperity of the
postwar period. Activists in both countries began
to question the status quo (Advisory Council on
Public Welfare 1966). In the United States, the
newly elected Democrats introduced several new
programs. In 1961, Aid to Families with Dependent
Children (AFDC) was amended to offer assistance
to the unemployed. Food stamps were introduced
in 1964, and the program was expanded in 1971
and 1974. Social Security amendments of 1962 and
1965 introduced federally funded social services and
health care programs for welfare recipients and the
retired. The Office of Economic Opportunity was
created in 1964 to fight President Johnson’s War
on Poverty.
The distinguishing feature of the North American
GAI experiments is that they were based on the idea
of a negative income tax or refundable tax credit.
Despite a GAI’s appeal to advocates for social jus
tice, its most wellknown advocate in North America
was Milton Friedman, who introduced the idea to
readers in two Newsweek columns and championed
the idea in his book Capitalism and Freedom (1962).
Support, however, was very widespread (Baumol
1974, 1977; Green 1967; Tobin 1966; Tobin, Pech
man, and Mieszkowski 1967).
3
Advocates saw a
GAI as addressing several problems simultaneously.
It would eliminate the “welfare trap” that discour
aged individuals from leaving welfare rolls and
created a strong disincentive to work in the form of
very high effective tax rates. Existing social assist
ance programs were riddled with overlaps and gaps
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that allowed some families to qualify under two or
more programs while others fell between programs.
A coordinated scheme offered as a GAI would elim
inate these inconsistencies. The most intransigent
poverty was that of the working poor, and a GAI
would be more effective than existing schemes in
reducing the prevalence of poverty among low
income workers. Finally, advocates argued, offering
all income support schemes in a coordinated fashion
and through a single bureaucracy would be more
efficient than a set of parallel bureaucracies ad
ministering inconsistent and overlapping programs.
Critics of a GAI worried that labour markets would
suffer under a negative income tax scheme because
individuals might reduce their work effort if they
received a minimum payout even if they chose not
to work. This last concern was the justification for
developing a set of GAI experiments that could
determine the effect of a GAI on work effort.
In the United States, the Office of Economic
Opportunity (OEO) advocated a negative income
tax as part of the antipoverty plan it developed
each year. However, traditional welfare advocates,
located largely in the AFLCIO, the Department
of Health, Education, and Welfare (HEW), and the
Department of Labor, were hesitant to adopt such a
scheme and argued that the social security scheme
first introduced in the 1930s had never been given
adequate support or the necessary resources to
address poverty. Far better to make incremental
changes to existing programs, they argued, than to
introduce an untested GAI scheme. As an alternative
to the OEO call, they recommended increased min
imum wages, unemployment insurance, expansion
of AFDC, increased Social Security benefits, better
manpower training, and full employment policies.
The OEO plan was introduced, debated, and put
on hold from 1965 until 1969 when Johnson left
office. Each year the latest plan was considered by
a White House task force. Support for the scheme
grew throughout the period. In 1965, Otto Eckstein
of the Council of Economic Advisors chaired one of
the task forces and explored a number of variations
of the scheme. A 1966 task force recommended
that a presidential commission review plans for a
negative income tax. While cautiously optimistic,
these task forces feared political opposition and
stopped short of advocating the implementation of
the scheme. A commission chaired by Ben Heineman
was established in 1968 and reported in 1969, after
Johnson had left office. The Heineman commission
recommended that the existing welfare scheme be
replaced by a negative income tax. By then, how
ever, the new president, Richard Nixon, had already
declared support for a more limited form of welfare
reform—the Family Action Plan (FAP).
When Nixon came to office, he appointed
Donald Rumsfeld to head the poverty program, and
Rumsfeld brought along an assistant, Dick Cheney.
Robert Levine, one of the original experimenters
who went on to work for the RAND Corporation,
credits Rumsfeld for saving the poverty program
by shifting it in a republican direction, toward
“experimentation rather than action” (Levine et al.
2005, 98).
The American GAI experiments began under
the OEO and continued within the Department of
Health, Education and Welfare after the Nixon ad
ministration abolished the OEO (Levine et al. 2005,
97). The experiments’ main goal was to establish
the size of the labour supply response to a GAI. As
the data began to emerge, investigators began to
ask other questions: How does a GAI affect human
and other capital accumulation? What is the effect
on family formation and fertility? How is health
affected?
The first experiment was conducted on an urban
population in New Jersey and Pennsylvania between
1968 and 1972. A second experiment was conducted
in Gary, Indiana, to examine the effect of a GAI
on single parents. A third experiment conducted
in North Carolina and Iowa looked at the effects
on rural populations. The final experiment was the
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SeattleDenver Income Maintenance Experiment
(SIMEDIME), which had access to a much larger
experimental population. These experiments were
the first largescale social experiments and were
consciously modelled on techniques from the nat
ural sciences: “We wanted to try science to find out
something very specific” (ibid.). The researchers
used a randomly selected experimental population
and matched controls. They collected quantitative
and qualitative data from both subjects and controls
to determine the effect of the GAI on a wide variety
of social behaviours.
The results of the experiments were debated
in policy circles and in the media at two different
times. In 1970, when the FAP was being debated in
the House and Senate, the administration encour
aged researchers to release results (Burke and Burke
1974). These preliminary results showed very mod
est labour market responses, but were dismissed by
critics as premature. In the late 1970s, during the
discussion of Jimmy Carter’s Program for Better
Jobs and Income, the results again attracted atten
tion. This time the modest labour market responses
did not attract nearly as much attention as another
finding: participants receiving a guaranteed annual
income appeared to have a significant increase in
the divorce rate relative to the controls.
The experiments generally found a 13 percent
reduction in work effort from the family as a whole,
with onethird of the response coming from the pri
mary earner, onethird from the secondary earner,
and the final third coming from additional earners in
the family (Levine et al. 2005, 99). Because the pri
mary earner typically worked many more hours than
the secondary and tertiary earners, this implied a
relatively small reduction in work effort by primary
earners. Female spouses reduced their hours and
reentered the workforce less quickly after a break.
The general result found in all the experiments was
that secondary earners tended to take some part of
the increased family income in the form of more
time for household production, particularly staying
home with newborns. Effectively, married women
used the GAI to finance longer maternity leaves.
Tertiary earners, largely adolescent males, reduced
their hours of work dramatically, but the largest
decreases occurred because they began to enter the
workforce later. This delay in taking a first job at
an older age suggests that some of these adolescent
males might be spending more years in school. The
biggest effects, that is, could be seen as either an
economic cost in the form of work disincentives or
an economic benefit in the form of human capital
accumulation.
The most challenging result, however, came in
the form of controversial family dissolution rates in
the SIMEDIME experiment (Hannan, Tuma, and
Groeneveld 1977). These results seemed to imply
that African American experimental families had a
divorce rate 57 percent greater than the controls,
while Caucasian experimental families had a di
vorce rate 53 percent greater than the controls. This
finding caused Senator Moynihan, early on one of
the strongest advocates for a GAI, to withdraw his
support and was largely responsible for the failure of
Jimmy Carter’s welfare reform scheme (Moynihan
1973). Further analysis of the data, published in
1990, rejected these findings as a statistical error,
and no other experiment found any effect on marital
stability (Cain and Wissoker 1990).
Other results were equally intriguing. In North
Carolina, children in experimental families showed
positive results in elementary school test scores. In
New Jersey, data on test scores were not collected,
but a positive effect was found on school con
tinuation rates. In SIMEDIME there were positive
effects on adult continuing education (Levine et al.
2005, 100). These results are all the more remark
able when juxtaposed to the academic literature
that shows it is very difficult to affect test scores,
dropout rates, or educational decisions by direct
intervention.
Inconsistent attempts were made to collect health
data, specifically on issues such as low birth weight,
which can be associated with significant deficits in
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later life. The Gary, Indiana, study found positive
effects on birth weight in the most atrisk groups
(ibid.).
By the late 1970s, the results showing very
modest effects on work effort were portrayed as
disastrous for the labour market. More extreme
reactions came from Senator Williams from New
Jersey, an opponent of the FAP, who argued that
the experimental families were “doubledipping”
and should be prosecuted for welfare fraud. David
Kershaw, who was then running the experiments,
went to great lengths to protect the confidentiality
agreements that families had signed and prevented
the congressional investigators unleashed by the
General Accounting Office from seizing the files
(Levine et al. 2005). Whatever the scientific merit of
the experiments, the political moment for a general
GAI in the United States had passed.
soCial seCurity reForm in Canada
In Canada, social security was also being trans
formed. After World War II, family allowances
were introduced. The Canada Pension Plan and its
counterpart in Quebec, designed to augment Old
Age Security and private pensions, was introduced
in 1966, although planning had begun in the late
1950s. Throughout the 1960s, debates about univer
sal health insurance culminated in a series of policy
changes that saw all provinces with fully complying
plans in place by 1972. Income support schemes
remained the responsibility of the provinces, but
the federal government increased its support of
provincial plans throughout the 1960s.
The idea of a universal minimum level of income
support for all Canadians was first recommended
by the Croll Committee’s report in 1971. In the
same year, the CastonguayNepveu Commission
of Quebec suggested a similar scheme. In the early
1970s, a Social Security Review reintroduced the
co ncep t. On the basis of these proposal s, the
Canadian government, in partnership with the
Province of Manitoba, conducted a GAI experiment,
MINCOME, between 1974 and 1979. At the time,
it was widely believed that this experiment would
serve as a pilot for a universal program, parallel to
universal health insurance, that would revolution
ize the ways in which Canadians pay taxes, receive
benefits, and earn income. However, the oil shocks
and persistent stagflation of the 1970s brought dif
ferent governments to power at both the federal and
provincial levels, and brought MINCOME to an end
without implementation of the anticipated universal
basic income proposal.
The idea was revived by the Royal Commission
on the Economic Union and Development Prospects
for Canada, known as the Macdonald Commission,
which reported in 1986. The economic turmoil
of the 1970s was past, but it had left a legacy in
the form of a relatively large federal deficit and
ongoing acrimony between the provinces and
the federal government. In this context, the royal
commission was established and given a broad
mandate to examine all aspects of the ways in
which the Canadian economy functioned. In 1982,
the commission was appointed under the direction
of the Right Hon. Donald Macdonald, formerly a
senior federal minister in the energy and finance
portfolios. One aspect of that overall review was to
look again at the arrangements for social security
provision across the country. Once again, a strong
case for a GAI in Canada was made in the Macdon
ald Commission’s 1986 report and in several of its
background research studies. The commission itself
described its proposals as “radical, not cosmetic,
and wholesale rather than tinkering at the margin”
(vol. 1, 48). Once again the excitement generated
by such a radical proposal did not translate into a
universal basic income scheme, although subsequent
governments continue to examine, build upon, and
reinvent the idea.
The commission’s report (vol. 2, 77883) docu
mented what were widely perceived to be limitations
with the current system: no national minimum
standard for assistance and consequently differential
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support levels between provinces; administrative
inefficiencies that left some families eligible to
receive benefits simultaneously from two or more
different programs; a confusing array of programs
that recipients often could not understand; and, most
importantly, an inability to deal with the working
poor. Welfare recipients were discouraged from
moving from support to the labour market, since
any earnings resulted in a dollarfordollar reduction
in their benefits.
The commission attempted to address these
defects with a Universal Income Security Program
(UISP), which would “simplify and rationalize the
existing aggregation of programs” (vol. 1, 49).
Aware of the cost of social programs and the context
of a federal deficit, the commission did not argue
that social expenditures for income support should
be reduced, but did suggest that there be “no in
crease in the cost of transfers and tax expenditures”
(vol. 2, 795). Perhaps fearing public reactions, the
commission insisted that its proposals should not
be considered a guaranteed annual income scheme
(ibid.). Nonetheless, a GAI is precisely what they
proposed. The design of the program would see the
UISP replace some existing programs. The pro
gram would be funded from reallocated program
expenditures from the discontinued programs and
therefore would impose no net cost. Families with
annual earned income in the $8,000 to $12,000
range (in 1984 dollars) could expect an increase of
$5,000 to $7,000. Families without other earnings
could expect a provincially funded and administered
“topup” since the UISP would replace only feder
ally mandated programs. In order to garner public
support, the commission suggested that payments
to young recipients might be dependent upon an
active job search, demonstrated earnings, or par
ticipation in locally administered training programs.
Moreover, payments to those under age 35 might
be restricted to half the payout level of those over
35 (vol. 2, 798).
More than two decades have passed since the
publication of the Macdonald Commission’s report,
and the fundamental problem of poverty amidst
plenty persists in Canada, as evidenced by the recent
call for further consideration of a GAI in the Senate
Committee report In from the Margins (2009). The
past few years have seen a reemergence of inter
est among social agencies as well as some federal
and provincial government departments in the idea
of a wholesale reform of social security along the
lines of a GAI.
minCome in Context
In March 1973, Manitoba submitted a proposal for
funding of a full experiment (rather than an adminis
trative test or pilot project) to the federal Department
of National Health and Welfare. It contemplated a
budget of $17 million and expected to enrol over
1,000 families, with Ottawa paying 75 percent of
the costs. On 4 June 1973, Manitoba and Canada
formally signed an Agreement Concerning a Basic
Annual Income Experiment Project covering cost
sharing and jurisdictional issues. The design of the
project selected families from two experimental
sites: Winnipeg and the rural community of Dauphin
in western Manitoba. A number of small rural com
munities were also selected to serve as controls for
the Dauphin subjects. The Winnipeg sample was
designed along the same lines as the American
experiments: subjects were randomly selected from
Winnipeg and paired with matched controls from the
same community. A major advantage of this design
was that subject families were isolated from one an
other, which made it possible to vary the parameters
of the negative income tax between families to get
precise estimates of the impact of program design on
work effort. The randomly drawn dispersed sample,
and the use of matched controls, also made it pos
sible to isolate the effects of the GAI and to draw
conclusions about causation. The main goal was to
gauge work response, and therefore the disabled,
the institutionalized, and the retired were excluded
from the Winnipeg experiment. This is the only part
of the experiment that received research attention,
and ultimately the findings were very similar to the
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US findings: secondary and tertiary wageearners
tended to have a moderate labour market response,
while primary earners showed little change in the
number of hours worked in response to registration
in the GAI (Hum and Simpson 1991).
The Canadian experiment, however, had one
unique feature: it was the only experiment to contain
a “saturation” site. Every family in Dauphin, with
a population of approximately 10,000 and another
2,500 living in its rural municipality, was eligible to
participate in the GAI. This time the elderly and the
disabled were included as they would be in a uni
versal program. The Dauphin site was explained as
an attempt to answer questions about administrative
and community issues in a less artificial environ
ment (ibid., 45). Michael Loeb, founding research
director, also suggested that researchers anticipated
that a relatively isolated community such as Dauphin
might exhibit aggregate demand effects.
4
The Dauphin cohort all received the same offer: a
family with no income from other sources would re
ceive 60 percent of the Statistics Canada lowincome
cutoff (LICO), which varied by family size. Every
dollar received from other sources would reduce
benefits by 50 cents. All benefits were indexed to
the cost of living. Families with no other income
who qualified for social assistance would see little
difference in their level of support, but for people
who did not qualify for welfare under traditional
schemes—particularly the elderly, the working poor,
and single, employable males—MINCOME meant
a significant increase in income. Most important
for an agriculturally dependent town with a lot of
selfemployment, MINCOME offered stability and
predictability; families knew they could count on
at least some support, no matter what happened to
agricultural prices or the weather. They knew that
sudden illness, disability, or unpredictable economic
events would not be financially devastating.
The experiment quickly ran into financial dif
ficulties (ibid., 437).
5
The original budget proved
very inadequate. The inflationary price increases
of the 1970s, coupled with a larger than anticipated
unemployment rate, meant that the proportion of the
total going to program expenses exceeded estimates
and was not under the control of the researchers. The
payments to families were inflation adjusted, but
the budget was not. Costs for data collection also
spiralled out of control because wages paid to staff
were not entirely under the control of researchers.
Analysis was the last claim on the budget, and it was
funded from an everdiminishing residual. These
financial challenges occurred at the same time that
the country itself was struggling with the economic
challenges of the decade. Persistent unemploy
ment and inflation that seemed to resist traditional
remedies soon attracted more attention from the
federal government than the problem of poverty
which, while important, was also longstanding.
Neither the provincial nor the federal government
was prepared to put more resources into MINCOME,
and new governments at the provincial and federal
level turned their attention to what they perceived
as more pressing issues.
Midway through the experiment, with political
support for the GAI waning, the project was altered
in two ways. First, research veered away from the
original focus on work incentives towards admin
istrative issues. Second, the project was directed
to adopt an “archive” strategy. That is, researchers
would collect and archive data, but not engage in
analysis. The first response of the researchers was
to cut peripheral research programs to protect the
core. Originally, there were to be four foci: an eco
nomic program that centred on work incentives; a
sociological program that looked at family forma
tion, community cohesiveness, social attitudes,
mobility, and the like; an administrative program;
and a statistical program. The sociological program
was the first to go. The researchers used ethno
graphic methods that were viewed with suspicion
by the quantitatively oriented senior research staff.
Research on the farm labour supply went next. It
had always been seen as a concession to Manitoba
agricultural interests but of no real interest or im
portance. It soon became clear that project resources
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3 2011
would not even allow reasonable estimates of labour
supply responses.
In the end the project ran for four years, conclud
ing in 1979, but the data collection lasted for only
two years and virtually no analysis was done by
project staff. New governments at both federal and
provincial levels reflected the changing intellectual
and economic climate. Neither the Progressive Con
servative government of Joe Clark in Ottawa nor
Sterling Lyon’s Tories in Manitoba were interested
in continuing the GAI experiments. The fate of the
original data—boxes and boxes of paper files on
families containing questionnaires related to all
aspects of social and economic functioning—was
unclear. They were stored in an unpublicized lo
cation by the Department of National Health and
Welfare. In the end, only the Winnipeg sample, and
only the labour market aspects of that sample, was
ever made available. The Dauphin data, collected
at great expense and some controversy from par
ticipants in the first largescale social experiment
ever conducted in Canada, were never examined.
reConsidering dauPhin
We believed the Dauphin saturation site had the
unique capacity to illuminate quality of life issues
consequent upon a general introduction of a GAI.
However, the Dauphin data were not easily access
ible; the National Archives housed a few obsolete
tapes based on the labour market results from the
Winnipeg sample and 1800 cubic feet of material
that had not been entered into a database. We turned
instead to a unique population health database main
tained in Manitoba.
Many people have argued that income security is
one of the social determinants of health (Dahlgren
and Whitehead 1991; Evans and Stoddart 1994;
Marmot and Wilkinson 1999). However, the pre
cise pathways by which income influences health
outcomes are less clear. Research has examined the
relationship between health and each of the related
concepts of mean family income, income distribu
tion, and the incidence of poverty. Our focus is on a
slightly different dimension of economic wellbeing:
income security, which is a concept distinct from
income or socioeconomic status. Income security,
the guarantee that all participants can expect a basic
annual income whether or not they work, gives
people a longer planning horizon, allowing them
to get beyond just making ends meet.
Income security is conceptualized in many differ
ent ways in the social science literature. Sometimes
it is treated in a way that makes it virtually indis
tinguishable from socioeconomic status or poverty
(Luckhaus 2000). More often, it is conceived as
periods of time on social assistance, or periods of
time below some significant marker such as the Sta
tistics Canada lowincome cutoff (LICO) (Sandefur
and Cook 1997; Yelowitz 1996; Harris 1996). We
claim that income security exists when the risk of
falling below a particular income level is minimized
(cf. Bertola 2004). That is, we conceived of the GAI
as an insurance policy. In the same way that people
who buy fire insurance on their houses perceive the
policy to be beneficial even if they never collect,
the GAI benefited everyone in the saturation site,
including families that never collected payments
under the scheme. The benefit to those who did col
lect payments is obvious, but those whose incomes
exceeded the threshold and therefore did not qualify
still benefited from the reduction of risk. Because
this is an agricultural community and even those
working in other sectors had incomes dependent on
harvests and agricultural prices, many people did
not know with certainty in advance whether or not
they would qualify for MINCOME stipends. The
health and social benefits, including the willingness
to encourage adolescent children to stay in school
rather than encouraging them to work, are dependent
on perceived risk and not directly on whether the
family qualified for support after the fact. One of
the effects that we expected might occur was that
more adolescents, and especially more adolescent
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
males, might continue high school beyond the man
dated age (Mallar 1977; Maynard 1977; Maynard
and Murnane 1979; McDonald and Stephenson
1979; Rea 1977; Weiss, Hall, and Dong 1980). We
accessed aggregate data on school continuation
rates from the Department of Education, presented
in Figure 1 below.
Money flo w e d t o D a u phin famili e s f r o m
MINCOME between 1974 and 1978. During the
experiment, Dauphin students in grade 11 seemed
more likely to continue to grade 12 than their rural
or urban counterparts, while both before and after
the experiment they were less likely than their urban
counterparts and not significantly more or less
likely than their rural counterparts to complete high
school. Grade 11 enrolments as a percentage of the
previous year grade 10 enrolments show a similar
pattern. (We could not disaggregate by gender.) This
figure is based on aggregate enrolment data provided
by the Department of Education and does not control
for underlying population dynamics. However, the
population of Dauphin was stable, and there were no
classification issues that we are aware of.
6
Although Dauphin was a saturation site, only
about a third of Dauphin families qualified for
MINCOME stipends at any point, and because of
the structure of the payment scheme, many of those
stipends would have been quite small. Why, then, is
the educational response so apparent in aggregate
data? Two factors, we suspect, are at work. First,
most children in highincome families already
continued into grade 12 and graduated from high
school. Most of the students at risk for leaving
high school early were in lowincome families that
would have either received MINCOME stipends or
believed there was a reasonable possibility that they
would qualify for the stipends. Therefore, atrisk
students were disproportionately likely to receive
or to expect to receive income supplementation.
Second, we suspect a social multiplier was at work.
Students in grade 11 trying to decide whether to
continue to grade 12 would consider two things.
Anticipated family income, including MINCOME
stipends, would be one. Young persons, however,
would also consider whether their friends intended
to stay in school; the more friends who decided to go
on to grade 12, the more likely our subjects would
0.0
20.0
40.0
60.0
80.0
100.0
120.0
Dauphin
Winnipeg
Non-Winnipeg
1971 1972 1973 1974 1975 1976 1977 1978 1979 1980
Figure 1
Grade 12 Enrolment as a Percentage of Previous Year Grade 11 Enrolment
Source: Compilation by author.
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292 Evelyn L. Forget
Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
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as well. Therefore, it matters whether the families
of their friends participated in the experiment. This
study estimates the total treatment effect; we cannot
separate out the direct effect from indirect effects
that might operate through social networks or other
market and nonmarket mechanisms (Scheinkman
2011). Ironically, the inability to randomize in a
saturation site, far from being a liability, may have
generated a response that would be invisible in a
classic randomized experimental site.
The Population Data Repository
The Manitoba Population Health Research Data Re
pository captures standardized data based on almost
every physician and hospital contact in the province;
this is data routinely collected for the administration
of public health insurance. The information (in
cluding patient and family identification numbers,
physician claims, diagnoses, costs, and hospitaliza
tion and institutionalization data) is maintained and
controlled by the provincial department of health.
All records deposited in the repository have been
processed by Manitoba Health to remove patient
identifiers such as name and address, while preserv
ing the capacity to link records together to form
individual and family histories of health care use.
Individual demographics, including marital status
and sixdigit postal codes of residence, are updated
every six months. The health records are linked to
vital statistics, so dates of birth and death, as well
as cause of death, are recorded (Roos et al. 1993;
Roos and Nicol 1999).
The database extends from 1970, when univer
sal health insurance was established in Manitoba.
Although the richness of the database has increased
over time, the outcome measures available for this
study are limited to hospital discharge abstracts,
physician claims, and vital statistics.
Selecting the Subjects and Comparators
Subjects included everyone who listed a home ad
dress in the Municipality or the Rural Municipality
of Dauphin continuously between January 1974 and
December 1978. Individuals who were born or died
between January 1974 and December 1978 were
included as long as they did not live elsewhere dur
ing the experiment. Individuals who moved into or
out of Dauphin or its rural municipality during the
period were excluded from both the experimental
and control groups as they were not considered part
of the experiment.
The perfect control for our research would have
been a second community identical in all respects
to Dauphin except that it did not receive the GAI.
Such a community does not exist. We could have
used several smaller communities as a control, as
did the original researchers. However, because we
were using health outcomes, it was essential to
match closely on age and sex. Moreover, commun
ity controls would have imposed a difficult data
problem. Not all communitylevel disturbances
are reflected in databases, but researchers need to
know when such events might be affecting data.
By using control subjects drawn from a variety of
communities, we could minimize the impact of such
events in communities other than Dauphin simply
by assuming that these effects offset one another in
the aggregate. We took into account events that were
specific to Dauphin as historians do—by reading
newspapers and government reports and by talking
to people who lived there.
We selected our dispersed control through a
combination of hardmatching and propensity score
matching. For every subject included, we selected
three other Manitoba residents as a comparison
group. First, we hardmatched on geography by
removing from the database of potential matches
all residents of Winnipeg (the only urban centre
in the province), First Nations reserves,
7
some
municipalities without reserve status but with large
populations of First Nations or Métis residents, and
people living in Northern Manitoba.
8
Winnipeg,
with a 1971 population of 535,100, was omitted
because access to health care, income, and life
style differed between Winnipeg and the rest of the
province in the mid1970s. The second largest town
in Manitoba was Brandon, with a 1971 population
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
of 31,544; we kept Brandon in the database from
which to select comparators because we assumed
that it was more similar to the town of Dauphin,
with a 1971 population of 12,173, than it was to
Winnipeg. We took First Nations reserves out of the
database because primary health care on reserve is
a federal responsibility, and therefore residents ac
cessing primary care on reserve will not appear in
a provincial database. We excluded towns without
reserve status that nonetheless had large propor
tions of First Nations or nonstatus Indian residents
because these towns are often just outside reserves
and residents sometimes access health care on the
nearby reserve. We excluded Northern Manitoba
because this sparsely populated region contains
large numbers of highly mobile young men work
ing in the resource industries, whose health care
utilization patterns can be expected to differ sub
stantially from those of residents of stable towns in
the agricultural heartland of the province. We also
removed all individuals who lived in Dauphin or its
rural municipality for only part of the period 1974 to
1978 and lived elsewhere for the rest of the period.
After these exclusions, we were left with small town
and rural residents living in the southern and central
parts of Manitoba—places very much like Dauphin
and its rural municipality.
From the people remaining in the database, we
used propensity score matching to select three
comparators for every subject. Variables used for
matching were limited by the data available to us
in the data repository. Matching variables included
year of birth, sex, number of people in the family,
whether the family resided in a small town or a rural
municipality, and whether the family was a single
parent, femaleled family. Adding a fourth control
reduced the quality of the controls significantly, but
at three controls for every subject, the balance was
excellent, with 99 percent matching exactly on sex
and birth year.
We have no way to identify the ethnicity, reli
gion, employment, or income of any individual in
our health database, and previous research shows
all of these may be related to health utilization pat
terns. We therefore turned to the 1971 Census to
determine whether there were any systematic dif
ferences between our subjects and comparators on
variables that might affect the outcomes. We used
communitylevel variables and weighted each com
munity by the number of people in our comparison
group who were drawn from that community. We
then compared these weighted results with those for
Dauphin and its rural municipality.
Of all the variables available to us from the 1971
Census, no income or employment variables were
significantly different. There were systematic dif
ferences between subjects and comparators only in
agricultural specialization and ethnicity.
9
Dauphin
agriculture was slightly more specialized in canola
cultivation than elsewhere in the province, with
a significantly larger proportion of census farms
reporting canola cultivation and a larger proportion
of improved land devoted to canola production.
However, agricultural differences, while significant,
were small and in any case unlikely to be associated
with outcome variables.
Ethnic and religious differences, however, could
affect some social outcomes and, in particular, may
have affected fertility and family formation out
comes. The proportion of the Dauphin population
claiming Ukrainian heritage, and, consequently,
Ukrainian Catholic or Ukrainian Orthodox religious
affiliation, was greater than the proportion of those
living in communities from which the comparators
were selected. In order to control for ethnic and
religious differences that we could not eliminate or
measure directly between subjects and comparators,
we designed a method to measure the impact of
MINCOME that would adjust for these differences.
Instead of simply measuring significant differences
in outcome variables between subjects and com
parators, we determined whether the gap between
subjects and comparators increased or decreased
during the experimental period. This method would
also adjust for any systemic differences in access to
health care as well as any other omitted variables
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Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
3 2011
between subjects and comparators that we were
not able to measure directly. The limitations of this
approach are discussed below.
Analysis and Results
Our primary outcome variables relate to health
care utilization. Hospitalization rates are generally
a better measure of poor health than contact with
physicians because patients tend to have less control
over the decision to be admitted to hospital than
they do over whether to consult a physician. Figure
2 displays annual hospitalization rates (hospitaliza
tions per 1,000 residents) for Dauphin relative to the
comparison group.
10
While patterns in the raw data are less appar
ent than was the case for Figure 1, it is clear that
hospitalization rates were approximately 8.5 percent
higher in Dauphin relative to the comparison group
when MINCOME began in 1974, and that this dif
ferential was quite stable from the time medicare
was introduced in 1970. During the project, the
hospitalization rate began to fall in Dauphin rela
tive to the controls, and by the end of 1978 there
was no significant difference between experimental
and control groups. Between 1973 and 1978, the
hospitalization rate in Dauphin declined by 19.23
per 1,000 residents (+/ 2.096 at the 95 percent
confidence level).
In order to examine the data more systematic
ally, we measured hospitalization and physician
contacts at sixmonth intervals from 1970 to 1985.
We constructed a segmented time series model and
Figure 2
Hospital Separation Rates for Dauphin Residents and Controls
Source: Compilation by author.
250
200
150
100
50
0
1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980
Dauphin
Controls
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
examined hospital separations, all causes; hospital
separations, accidents and injuries; hospital separa
tions, noncongenital mental health; and physician
visits.
11
Table 1 presents definitions of independent vari
ables. Parameter estimates are presented in Table 2.
The first column in Table 2 presents model
results for the dependent variable “hospital separa
tions.”
12
All variables except the binary variables
“Mincom” and “Nomincom” are significant at the
1 percent level. Results suggest that before MIN
COME began in 1974, the rate of hospitalization in
Dauphin was significantly higher than the rate for
the comparison group (depend > 0). The interaction
term (yrmincome*depend) was significant and nega
tive, which suggests that the gap between Dauphin
residents and their comparators narrowed beginning
in 1974 when the MINCOME money began to flow.
By the end of 1978 there was no significant differ
ence between Dauphin residents and the controls.
The gap apparent before 1974 did not reopen before
1985 when we stopped following the subjects.
13
None of the health or census variables that we
examined could explain the persistent gap between
subjects and controls before 1974, but we note that
there was a fairly new hospital in Dauphin, which
may have led to some supplyinduced demand.
Some, but not all, of the comparison group would
have lived near a hospital, and it is certainly pos
sible that some of the comparison group may have
had less convenient access to hospitals than the
Dauphin residents, leading them to forgo voluntary
treatment. The gap may also reflect the influence of
other variables for which we could not control, such
as ethnicity. The outcome of interest, however, is
the fall in hospital separations for Dauphin residents
relative to the comparison group over the course of
the MINCOME project.
We wondered whether these patterns would
persist if we looked more carefully at particular
causes of hospitalization that we expected to be
especially sensitive to income insecurity. First,
we examined the hospital separation rate for “ac
cidents and injuries,” which are identified by ICD9
codes
14
and include such things as workplace and
Table 1
Denitions of Independent Variables
Variable Denition
Intercept
Depend 1 if the individual lived in Dauphin throughout 1974–78; 0 otherwise
Time_Seq Sequence of six month time intervals from 1970–85 (1,2,3 … 32)
Mincom Binary variable dening MINCOME period (1974+)
Yrmincom Sequence of six month time intervals beginning 1974 (1,2 … 24)
Nomincom Binary variable dening the period after MINCOME (1979+)
Yrnomincom Sequence of six month time intervals beginning 1979 (1,2 …14)
Yrmincom*Depend An interaction term that allows a dierential rate of change between Dauphin subjects and the comparison
group during and after the MINCOME period
Source: Compilation by author.
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296 Evelyn L. Forget
Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
3 2011
farm accidents, automobile accidents, and so on. We
expected “accidents and injuries” to be sensitive to
income security, both because we have found these
codes to be related to socioeconomic status in the
past, and because many of the particular reasons one
might be hospitalized with an “accident and injury”
code are clearly related to the stress that might be
induced by income insecurity. For example, farm
or workplace accidents may be related to income
insecurity if people continue to work in dangerous
jobs when they are unwell or fatigued. Children suf
fer farm accidents if parents are unable to provide
childcare during crucial harvest periods. Increased
alcohol use may be associated with higher rates of
family violence, automobile accidents, assaults, sui
cide attempts, and so on. It is important to remember
that these codes are assigned in smalltown hospitals
by people who are often neighbours, friends, or
relatives of patients, and the precise nature of the
accident or injury may be less clearly coded than it
would be in a large city hospital, particularly if some
socially sensitive issue is involved. Therefore, we
did not attempt to break down “accident and injury”
hospitalizations further.
Again, results seem feasible and consistent with
the overall rates of hospital separations. This time
there is a modest increase in “accident and injury”
Table 2
Segmented Time Series Model Outcomes Using a Negative Binomial Distribution
Variable Hospital Separations Physician Claims
Overall Acc+Inj Mental Health Mental Health
Intercept –2.5023* –5.1478* –6.0173* –2.3815**
(0.0226) (0.0502) (0.0749) (0.0613)
Depend 0.1336* 0.2062* 0.4923* –0.1027
(0.0150) (0.0340) (0.0464) (0.0394)
Time_Seq 0.0292 * 0.0582* 0.0867* 0.0142
(0.0042) (0.0093) (0.0137) (0.0118)
Mincom 0.0439 –0.1358 –0.0433 –0.0490
(0.0254) (0.0539) (0.0768) (0.0698)
Yrmincom –0.0445 * –0.0549* –0.0844)* –0.0086
(0.0052) (0.0113) (0.0165) (0.0144)
Nomincom –0.0409 0.0411 0.2060 0.0881
(0.0228) (0.0489) (0.0659) (0.0592)
Yrnomincom 0.0214* –0.0135 0.0342 0.0199**
(0.0036) (0.0076) (0.0104) (0.0094)
Yrmincom*Depend –0.0107* –0.0110* –0.0315* –0.0089**
(0.0013) (0.0030) (0.0037) (0.0032)
Note: Parameter estimates are presented. Standard Errors are in parentheses. The negative binomial dispersion parameter was estimated
by maximum likelihood.
*Signicant at 1 percent level
**Signicant at 5 percent level
Source: Compilation by author.
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
hospitalizations over the entire period for both
groups. Again, Dauphin residents enter the 1970s
with a significantly higher rate of hospitalization
than the comparison group, but this gap narrows
over the MINCOME period, until by the end of it
there is no significant difference between Dauphin
subjects and the comparators. Again, the differ
ential does not reemerge during the period under
consideration.
We wondered whether “mental health” hospital
separations would follow a similar pattern. Again,
we used ICD9 codes to select relevant cases and
omitted all “congenital” cases so that what we
were left with were instances of hospitalization for
anxiety disorders, clinical depression, personal
ity disorders, and so on. Note that we include the
hospitalization of individuals wherever they are
hospitalized, so that even if an individual from
Dauphin is hospitalized in a centralized provincial
facility (in Winnipeg, for example), we capture that
hospitalization. This may be of greater significance
in the case of mental health hospitalizations, which
tended to be more highly concentrated in particular
facilities, especially during the 1970s.
Hospital separations due to mental health diagno
ses follow a pattern very similar to that of accidents
and injuries. Again, the initial gap reflects a greater
hospitalization rate for Dauphin residents at the
beginning of the MINCOME period that narrows
during the period of the GAI and disappears by the
end of the period.
The second broad category of health care utiliza
tion variables available to us relates to the use of
physicians. Every contact with a physician results
in an entry in the database that includes the reason
for the visit and the amount billed. Hospital sep
aration data are excellent measures of health status
because individuals typically have limited control
over whether they will be hospitalized. Physician
contacts, however, are to a large degree under the
control of individual patients. Therefore, rather
than objective health status, physician claims might
represent a more subjective measure of health status,
which might be sensitive to income insecurity.
15
We examined overall physician claims, physician
claims for “accident and injury” diagnoses, and
physician claims for mental health diagnoses. Only
the latter showed significant trends, and parameters
are significant only at the 5 percent level. The pat
tern is similar to that of hospital separations for
mental health diagnoses, with the trend for Dauphin
residents falling relative to the comparison group
during the MINCOME period.
Finally, we tried to determine whether the GAI was
related to birth outcomes, fertility, or family dissolution
in Dauphin. Keeley (1980a, 1980b) found positive ef
fects on fertility, and Kehrer and Wolin (1979) found a
reduction in lowbirthweight infants in some urban cen
tres in the American experiments. Hannan, Tuma, and
Groeneveld (1977) claimed to have found an increase
in family dissolution rates in the SeattleDenver experi
ment, a nding contested by Cain and Wissoker (1990).
The Manitoba data allow us to investigate, to some
degree, each of these claims for the Dauphin subjects.
We found no evidence that fertility increased
among Dauphin subjects relative to the comparison
group. In fact, there is weak evidence of delayed
childbirth among the youngest cohort of Dauphin
mothers examined, although ethnic and religious
differences between subjects and comparators make
attribution of differences to MINCOME suspect.
Table 3 shows the proportion of women with at least
one child before age 25 by the mother’s birth cohort.
The proportions were significantly different only for
mothers born between 1967 and 1974 (Satterthwaite
ttest (twosided); 5 percent sig.).
Table 4 shows the mean number of children born
to women in each age cohort before age 25. The mean
number of children born to women before age 25 was
signicantly different between Dauphin subjects and
controls only for mothers born between 1967 and 1974,
with Dauphin women having signicantly fewer babies
(Satterthwaite ttest (twosided); 5 percent sig.).
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298 Evelyn L. Forget
Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
3 2011
If anything, women born between 1967 and 1974
who lived in Dauphin during the MINCOME period
were signicantly less likely than the comparison
group to give birth before age 25 and had, on average,
signicantly fewer children before age 25. This seems
to suggest delayed childbirth and may be indicative
of lower lifetime fertility. These women would have
been younger than seven at the start of MINCOME
and no more than 11 when the experiment ceased.
Their older sisters, born between 1960 and 1966,
who would have been between eight and 14 at the
beginning of MINCOME and between 11 and 18 at its
end, were no less likely than their comparators to give
birth early. This pattern makes it difcult to attribute
declining early fertility to MINCOME. We note that
there were ethnic and religious differences between
the Dauphin subjects and the comparison group
and, while we could not isolate any factor to which
we could attribute the difference, it is likely that
changes in religious education or social behaviour
unrelated to MINCOME might account for declin
ing fertility.
16
One difference between our subjects
and controls relates to religious afliation and its
potential impact on fertility. The speed of the social
changes related to fertility that occurred in all rural
areas during the 1970s may not have been uniform
across the province. We found no documented chan
ges in church teaching and were unable to document
any systematic social changes that may have led to
differential outcomes, but the possibility remains.
17
Table 3
Proportion of Women with at Least One Child by Age 25
Birth Cohort Dauphin Subjects Comparison Group
1946–52 0.69579 0.69794
1953–59 0.54742 0.54545
1960–66 0.46804 0.48605
1967–74 0.44969 0.51091
Source: Compilation by author.
Table 4
Mean Number of Children before Age 25 by Mother’s Birth Cohort
Birth Cohort Dauphin Subjects Comparison Group
1946–52 1.20227 1.24295
1953–59 0.91181 0.93780
1960–66 0.66667 0.65969
1967–74 0.65723 0.81944
Source: Compilation by author.
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
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One of the strongest claims made by individuals
who advocate a GAI is that birth outcomes will
improve; better nutrition and access to prenatal
care, it is argued, will lead to healthier newborns.
The only data we were able to use to determine
birth outcomes were perinatal deaths—extremely
rare events—and birth weight. The detailed birth
records of recent years, with one and five minute
APGAR scores
18
and other data, were not available
for the mid1970s. We tested for significant differ
ences in low birth weight, atrisk birth weight,
19
and smallforgestational age newborns born to
Dauphin subjects and comparison group members
during the MINCOME period. No significant dif
ferences were found. While numbers were small,
we attribute this finding to the institutional features
of the jurisdictions under study. Low birth weight
is usually attributed to a lack of prenatal care and
poor maternal nutrition during pregnancy. Univer
sal health insurance existed during the MINCOME
period in Manitoba and therefore, in principle, both
our Dauphin subjects and the comparison group had
equal access to prenatal care. Moreover, both Dau
phin subjects and comparison group members lived
in rural, agricultural areas of the province. Poverty
rarely manifests as food insecurity in such settings
where subsistence farming, hunting, and fishing
supplement purchased food, and social organizations
such as churches and clubs would have met residual
need (Rhyne 1979).
The most politically charged outcome claimed
by US researchers was that marital stability was
undermined in jurisdictions that experimented with
a GAI (Hannan, Tuma, and Groeneveld 1977). The
argument, which held great sway in the US political
debate, was that poor women, given a real choice
by the existence of a GAI, would be less inclined
to stay in unsatisfactory marriages. That finding
was suspect from the outset
20
and was convincingly
challenged by Cain and Wissoker who argued that
statistical errors destroyed the credibility of the find
ing (1990). Nevertheless, we examined our data to
see if family dissolution rates might be affected and
found no evidence of increased family dissolution
rates among the Dauphin subjects.
The population health data repository is routinely
updated every six months with family data, includ
ing residence of both parents and marital status. The
currency and accuracy of the data, however, depend
either on individuals calling Manitoba Health with
new information or physicians updating informa
tion during routine interactions with the health care
system. The latter happens regularly, but individuals
who have few contacts with the health system have
little incentive to update information. The data qual
ity, therefore, may be suspect.
ConClusions
We took advantage of an historical accident to re
examine the impact of a Guaranteed Annual Income
in the small town of Dauphin, Manitoba, which
served as the only saturation site in the five North
American Negative Income Tax field experiments of
the 1970s. Because universal health insurance was
introduced in this jurisdiction just before the MIN
COME experiment, we were able to access health
administration data to determine whether popula
tion health might be affected by a GAI. We used
a quasiexperimental design to determine whether
contacts with the health care system declined among
subjects who lived in the experimental community
relative to a comparison group matched by age, sex,
geography, family type, and family size. We found
that overall hospitalizations, and specifically hos
pitalizations for accidents and injuries and mental
health diagnoses, declined for MINCOME subjects
relative to the comparison group. Physician claims
for mental health diagnoses fell for subjects relative
to comparators.
Overall, the measured impact was larger than
one might have expected when only about a third
of families qualified for support at any one time and
many of the supplements would have been quite
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300 Evelyn L. Forget
Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
3 2011
small. This we attribute to social interaction. Be
cause Dauphin was a saturation site, the involvement
of friends and neighbours in the scheme may have
led to changes in social attitudes and behaviours
that influenced individual behaviour even among
families that did not receive the supplement. This
interaction may have reinforced the direct effects
of income supplementation. We were unable to
substantiate the claims of US research showing in
creases in fertility rates among subjects relative to
controls, improved neonatal outcomes, or increased
family dissolution rates.
These results would seem to suggest that a GAI,
implemented broadly in society, may improve health
and social outcomes at the community level. At the
very least, the suggestive finding that hospitalization
rates among Dauphin subjects fell by 8.5 percent
relative to the comparison group is worth examin
ing more closely in an era characterized by concern
about the increasing burden of health care costs. In
1978, Canada spent $7.5 billion on hospital costs; in
2010 it was estimated to have spent $55 billion—8.5
percent of which adds up to more than $4.6 bil
lion. While we recognize that one must be careful
in generalizing potential health system savings,
particularly because we use hospitals differently
today than we did in 1978, the potential saving in
hospital costs associated with a GAI seems worthy
of consideration.
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Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
Appendix
We found significant differences in the following variables in the 1971 Census (95 percent confidence level):
Percent reporting Ukrainian heritage (31.22 percent in Dauphin; 10.43 percent comparators)
Percent reporting religion as Ukrainian Catholic (16.70 percent Dauphin; 5.25 percent comparators)
Percent reporting religion as Ukrainian Orthodox (9.61 percent Dauphin; 2.25 percent comparators)
Percent improved land in rapeseed [canola] (9.36 percent Dauphin; 3.67 percent comparators)
Percent census farms reporting rapeseed [canola] (46.92 percent Dauphin; 18.40 comparators)
We found no significant differences on the following variables:
Average family income
Percent families with less than $2,000
Average household income
Percent households with less than $2,000
Average wage and salary income
Median wage and salary income
Percent wage and salary earners who are fulltime, fullyear
Average male employment income
Median male employment income
Average female employment income
Median female employment income
Average male total income
Median male total income
Average female total income
Median female total income
Male unemployment rate
Female unemployment rate
Percent males (15+) who never worked
Percent females (15+) who never worked
Percent British Isles ethnicity
Percent Native Indian ethnicity
Percent French ethnicity
Percent Polish ethnicity
Percent German ethnicity
Percent reporting religion as Roman Catholic
Percent reporting religion as United Church
Percent reporting religion as Mennonite
Percent reporting religion as Anglican
Percent reporting religion as Roman or Ukrainian Catholic
Percent occupied dwellings owned by resident
Average number of persons per room (all housing)
Percent owneroccupied nonfarm dwellings with no mortgage
Percent improved land in wheat
Percent census farms reporting wheat
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302 Evelyn L. Forget
Canadian PubliC PoliCy – analyse de Politiques, vol. xxxvii, no.
3 2011
Average acres in wheat on farms reporting wheat
Percent improved land in oats
Percent census farms reporting oats
Average acres in oats on farms reporting oats
Percent improved land in barley
Percent census farms reporting barley
Average acres in barley on farms reporting barley
Percent improved land in tame hay
Percent census farms reporting tame hay
Average acres in tame hay on farms reporting tame hay
Percent improved land in flaxseed
Percent census farms reporting flaxseed
Average acres in flaxseed on farms reporting flaxseed
Percent farms reporting cattle
Average number cattle on farms reporting cattle
Percent farms reporting pigs
Average number pigs on farms reporting pigs
Percent farms reporting chickens
Average number chickens on farms reporting chickens
Percent farms reporting laying hens
Average number laying hens on farms reporting laying hens
Percent farms reporting turkeys
Average number turkeys on farms reporting turkeys
Improved acres on census farm
Percent improved acreage sprayed or dusted for insect or disease control
Percent improved acreage dusted for weed or bush control
Capital value per census farm
Total sales per census farm
Percent farms with sales > $10,000
Percent farms with sales < $2,500
Farm output/capital ratio
Percent census farms owned by resident
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The Town with No Poverty 303
Canadian PubliC PoliCy analyse de Politiques, vol. xxxvii, no.
3 2011
notes
I am indebted to Charles Burchill and Oke Ekuma for pro
gramming assistance, to Stephenson Strobel for research
assistance, to CIHR for financial support (MOP 77533),
and to Manitoba Health for data access. No official en
dorsement by Manitoba Health is intended, nor should it
be inferred. I’d also like to thank two referees for helping
me turn a very chatty presentation into a marginally less
sprawling paper.
1 A Globe and Mail article on the topic by Erin Anderssen
published in November 2010 attracted 1,438 comments.
2 The Public Health Agency of Canada (PHAC), for
example, has established a working group on “upstream
interventions” that is specifically examining the idea of
GAI among other interventions.
3 American economists have shown strong support for
a GAI even after the field experiments of the 1970s. A
1979 survey reported in the American Economic Review
found 92 percent of respondents supporting the state
ment “The government should restructure the welfare
system along the lines of a negative income tax.” When
the same proposition was put to members of the National
Tax Association in 1994, 86 percent of economics profes
sors agreed, although a smaller proportion of other NTA
members was supportive (Chalk 1996, 5; Kearl et al.
1979; Slemrod 1995)
4 Email from Michael Loeb to the author (5 September
2005).
5 In addition to referenced works, details of MIN
COME’s operation come from discussions with Ron Hikel,
the senior Manitoba civil servant charged with overseeing
the experiment, and with research directors Michael Loeb
and Derek Hum and other participants in the experiment.
6 We looked specifically at the Indian residential school
in Dauphin to ensure that our data were not picking up an
influx of students into the public system, and we found
no evidence that this occurred.
7 Most, but not all, people living on reserve would
have First Nations status, but not all First Nations people
live on reserve.
8 Northern residents were identified as those living in
Statistics Canada Census Division 16.
9 95 percent level of confidence. Variables considered
are listed in the Appendix.
10 Hospitalization rates were calculated based on the
Discharge Abstract Database for fiscal years (April 1
to March 31). Denominators were calculated based on
number of subjects and number of controls, respectively,
who were alive on 1 April.
11 The models were run with the GENMOD procedure
in SAS with a negative binomial distribution and the log
population as an offset variable, which allows output to
be represented as rates instead of counts.
12 Hospital separations are separate events of hos
pitalization. The Hospital Separation Abstract that is
completed for each hospitalization event includes up to
ten diagnostic codes and number of days hospitalized,
among other data.
13 We did not allow for clustering of multiple ob
servations of the same individual, so we are likely
underestimating the standard error.
14 We used ICD9 codes because the longest run of
health data has been coded as ICD9. Over the period
1970–2008 the coding changed, and each transition re
quires careful consideration.
15 There is no evidence to suggest that the ratio of
physicians to population trended differently in Dauphin
from that in the rest of the province.
16 The files we pulled for analysis were limited to
people who were alive between 1974 and 1978. There
fore, we were unable to determine whether this pattern
persisted for younger age cohorts. We analyzed fertility
by age cohort because there were too few births in any
one year to test for significant differences.
17 We interviewed Roman Bosyk, a Ukrainian Ortho
dox priest who lived in Dauphin during the period, who
is currently dean of theology at St Andrew’s College,
Manitoba; he could think of nothing that should have led
to differential fertility outcomes in Dauphin relative to the
comparators. We suspect a greater general acceptance of
birth control among all rural residents during the 1970s,
and we note that the combined Roman and Ukrainian
Catholic affiliations between subjects and comparators
according to the 1971 Census is not significantly different.
Nonetheless, we note the potential confounding.
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3 2011
18 The APGAR score was devised by Dr Virginia Apgar
in 1952 to assess the health of newborns. The attending
physician evaluates the baby on five criteria (Appearance,
Pulse, Grimace, Activity, Respiration) on a scale from
zero to two, which are then summed to yield an APGAR
score between zero and ten.
19 “Atrisk birth weight” includes both very small and
very large babies, the latter often the consequence of
gestational diabetes. Both categories are associated with
poor health and with poverty.
20 There were a number of issues with the finding,
but one worth noting is that many of the families in the
comparison group would have received AFDC, which
specifically did not pay support to families with male
heads,while the families receiving a GAI faced no such
restriction. Intuitively, the AFDC families should have
had the greater incentive to dissolve marriages.
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2011 Fellowship and Governor’s
Awards Recipients
The Bank of Canada is pleased to announce
that Professors Randall Morck of the
University of Alberta and Gregor Smith of
Queen’s University are the recipients of the
Bank’s 2011 FELLOWSHIP AWARD.
The Fellowship Award is designed to
encourage leading-edge research, and to
develop expertise in Canada in a number of
areas important to the Bank’s mandate:
macroeconomics, monetary economics,
international finance, financial markets and
institutions, financial stability and
regulation, labour economics, and economic
growth.
The Bank is also pleased to announce that
Professor Thorsten Koeppl of Queen’s
University is this year’s recipient of the
GOVERNOR’S AWARD.
The Governor’s Award recognizes
outstanding academics, at a relatively early
stage in their careers, who are working at
Canadian universities in areas important to
the Bank's mandate.
The application deadline for the 2012
Fellowship and Governor’s awards is
15 November 2011.
For more information on the Fellowship
Program, call 613 782-8888 or visit our
website at:
www.bankofcanada.ca/fellowship.
Lauréats de la
Bourse de recherche et de la
Bourse du gouverneur de 2011
La Banque du Canada a le plaisir d’annoncer que
Randall Morck, professeur à l’Université de
l’Alberta, et Gregor Smith, professeur à
l’Université Queen’s, sont les lauréats de la
BOURSE DE RECHERCHE de la Banque pour
2011.
La Bourse de recherche est conçue pour
encourager la recherche de pointe et développer
l’expertise canadienne dans des domaines qui
sont au centre du mandat de l’institution, soit la
macroéconomie, l’économie monétaire, la
finance internationale, les marchés financiers et
les institutions financières, la stabilité et la
réglementation financières, ainsi que l’économie
du travail et la croissance économique.
La Banque est également heureuse d’annoncer
que M. Thorsten Koeppl, professeur à
l’Université Queen’s, est le lauréat de la
BOURSE DU GOUVERNEUR de cette année.
La Bourse du gouverneur vise à reconnaître des
universitaires de haut niveau qui ont commencé
leur carrière il y a relativement peu de temps, qui
sont employés par une université canadienne et
qui travaillent dans les domaines qui sont au
centre du mandat de la Banque.
La date limite de soumission des candidatures
pour la Bourse de recherche et la Bourse du
gouverneur de 2012 est le 15 novembre 2011.
Pour de plus amples renseignements sur le
programme, téléphonez au 613 782-8888, ou
consultez notre site Web :
www.banqueducanada.ca/bourses.
CPPInsidev37n3.indb 306 06/09/11 10:41 AM
... 34 Others argue that experiments are, by their nature, temporary and the behaviour of people who receive a temporary basic income might not mirror the effects of permanent program changes, that experiments cost a lot and take time to conduct and analyze. 35 37 Systematic reviews invariably note that the quality of many of the studies that have been conducted is variable and it is difficult to compare outcomes. 38 Yet, there is much to learn from well-conducted basic income experiments. ...
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... Decades ago, a similar Canadian minimum income experiment (Minicome) involving 1,300 households and a rigorous research component from 1975-1979 ended before producing a final report (Hum & Simpson, 1993). Although some of the original data was lost, participants later reported measurable improvements in the community's health as a result of its poorest members receiving a guaranteed cash supplement (Forget, 2011). Archival qualitative accounts also suggest that the experiment provided income benefits without stigma and helped to break down the distinction between the "deserving" and "undeserving" poor (Calnitsky, 2016). ...
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... Experiencia entre 1974-1979 conocida como Mincome. Estudiado por Evelyn L. Forget (2011) en El pueblo sin pobreza. Concedía a toda la población una asignación mensual inversamente proporcional a su nivel de ingresos, denominada BIG (Basic Income Guarantee). ...
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... In our analysis, we had subjective health as an independent variable, although health might be affected by the recipiency of basic income (as argued e.g. by Forget, 2011Forget, , 2018. This constitutes an alternative pathway through which universal policies drive trust and is an important avenue for future research. ...
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... Specifically, the principles for a holistic tax system developed in Section 2.1 based on pragmatic considerations identify negative income tax and basic income guarantee as inadmissible. Positive and negative aspects of these other proposed tax systems have been extensively discussed [9][10][11][12][13][14][15][16]. The tax system developed here escapes the pitfalls of negative income tax [17]. ...
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How can an income tax system be designed to exploit human nature and a free market to create a poverty free society, while balancing budgets without disproportional tax burdens? Such a tax system, with universal character, is deduced from the following guiding principles: (1) a single tax rate applies to all income types and levels; (2) the tax rate adjusts to satisfy budget projections; (3) government transfer only supplements the income of households with self-generated income below the poverty line; (4) deductions for basic living expenses, itemized investments and capital losses are allowed; (5) deductions cannot be applied to government transfer. A general framework emerges with three parameters that determine a minimum allowed tax deduction, a maximum allowed itemized deduction, and a maximum deduction defined by income percentage. An income distribution that mimics the United States, and a series of log-normal distributions are considered to quantitatively compare detailed characteristics of this tax system to progressive and flat tax systems. To minimize government dependency while maximizing after-tax income, the effective tax rate (ETR) as a function of income percentile takes the shape of the letter, V, inspiring the name victory tax, where the middle class has the lowest ETR.
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Chapter
This chapter discusses different aspects related to the decision to conduct UBI experiments. We start by asking to what extent moral and instrumental arguments are used to justify implementing these kinds of experiments and basic income-related policies. Although these two arguments mostly work together when experimenting, the second section of this chapter argues that scientists and politicians in charge of rolling out these experiments or implementing these kinds of policies differ in their respective logic and procedures, and these differences inevitably affect the design, implementation, and evaluation of basic income experiments and related programs. However, the decision to implement a basic income experiment is not solely explained by these different scientific and political decisions. The third section of the chapter addresses the role of the political scenario and the actual political debate in explaining when, how, and in what manner an experiment or a policy is about to be implemented, or on the contrary, why it is rejected. Moreover, the structure, logic, and functioning of the welfare regime model and of existing social policies also frame the discussion around the (in)convenience of implementing a basic income experiment or rolling out a similar in-cash policy. Finally, our last section explores the hypothesis that UBI experiments’ features are more due to political reasons than scientific ones.
Chapter
This chapter will introduce general lessons from the interviews, mapping out key conclusions in terms of context of and methodologies implemented to evaluate results in each case study. It will start by discussing the main conclusion from the interviews: how each of our case studies differ tremendously—in terms of their main characteristics and their general goals and details. This leads to a discussion of how our case studies can be construed as basic income experiments, pilots, or policies (or not). From there, we will raise key questions on the methodological decisions, either in terms of design model, type of evidence collected, and even the way ethical criteria can sometimes be taken into account. This discussion leads us to conclusions on the role the sociopolitical context plays in any basic income experiment and can therefore have tremendous impacts on how experiments are conducted, implemented, and perceived. The chapter closes with key conclusions from the interviews related to the implications of methodological decisions and context, specifically the limited comparability and scalability that basic income experiments offer so far.
Chapter
Social interactions refer to particular forms of externalities, in which the actions of a reference group affect an individual’s preferences. In the presence of strategic complementarities, social interactions help reconcile the observation of large differences in outcomes in the absence of commensurate differences in fundamentals. This article surveys the theoretical literature and discusses different approaches to estimating social interactions.
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