Today the Commission for the Review of Social Assistance in Ontario released its much anticipated options paper. The paper sets out some interesting ideas and poses some challenging questions that will help to shape the debate around social assistance in the coming months.
In our submission to the Commission, we started by arguing that the cornerstone of reform is starting from a vision of a high-performing social assistance system. We argued that such a system should be:
- Adequate: so that people on social assistance can maintain a healthy standard of living;
- Flexible: with a range of responsive supports to help people get out of poverty – recognizing that there are very different pathways into and out of poverty;
- Person-centred: so services and requirements are responsive to individual and family needs and situations, are delivered in a respectful manner that does not undermine dignity, and so people can be empowered to achieve more control over their lives; and
- Health-enabling: so that people’s opportunities for better health are enhanced, not constantly eroded.
In the options paper released today, a vision is set out of “a 21st century income security system that enables Ontarians to live with dignity, participate in their communities, and contribute to a prospering economy.”
While this is a good start, the vision is not embedded in the document. The vision does not identify the components of a high-performing social assistance system and, as a result, the Commission has not articulated a clear vision in their ideas for reform. In their introductory note, the Commissioners argue that “we need to transform the social assistance system; small fixes will not be enough.” We agree, and to do this a more comprehensive vision needs to be built into reforming the system.
A cornerstone of our advice to the Commission was that the social assistance system needs to be health-enabling. The measure of a health-enabling system is not whether people on social assistance have access to health care when they’re sick – although this is important – but rather whether the system can prevent people from getting sick to begin with. This means providing health benefits, but also ensuring that social assistance rates and supports are sufficient to cover essential items that enable good health like housing, nutritious food, and child care.
Unfortunately, the Commission’s report frames health very narrowly as a question of whether people on social assistance can get health care when they need it – they did not fully recognize that health and well being are affected by other social and economic factors. The Commission rightly identified that exiting social assistance is difficult when the employment that people move into does not offer health benefits and other essential supports like child care or housing and that this can create a situation where people are forced to remain on social assistance. But they did not make the connections between enhancing these kinds of supports and building good health. Our submission set out the nature of this problem and explained how disincentives to exiting social assistance can be reduced or eliminated by providing more flexible supports and building a system that recognizes that individual needs are different and change over time.
The Commission also did not adequately address how a broad range of wider social determinants affect health: issues like the barriers that immigrants face in entering employment, income inequality, and the lack of affordable housing are only addressed as examples of areas of intergovernmental tension, not as factors that have significant population health impacts.
Throughout their report, the Commission talks about the need for social assistance to be fair to everyone. They argue that it is unfair for a low-wage worker to not receive health benefits while a person exiting social assistance who works alongside them retains their benefits. The Commission is right – this isn’t fair. But the reason that it isn’t fair is because the low-wage worker doesn’t have benefits, not because the person exiting social assistance does. We cannot penalize people on social assistance for the labour market’s failures.
This is why we argued for a system based on equity rather than just an abstract notion of fairness. Equity is about addressing differences in outcomes that are avoidable, unfair and systematically related to social inequality and disadvantage. Equity means that people with different needs are supported in different ways. The Commission needs to avoid taking benefits away from people who need them in the interest of rigid uniformity in the name of fairness.
We’ll be digging deeper into the Commission’s report over the coming days and will continue to blog our analysis. In the meantime, we encourage you to review our recent work on social assistance, including our blogs on creating a vision of a high-performing social assistance system, building a basket of essential supports, supporting people on social assistance into training and employment, building on health promotion and primary care initiatives, and collaborative solutions to fixing social assistance.