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加拿大考虑实行基本收入保障:它能实现全民健康吗?

Canada considers a basic income guarantee: can it achieve health for all?

作者信息

Raphael Dennis, Bryant Toba, Mendly-Zambo Zsofia

机构信息

York University, School of Health Policy and Management, 4700 Keele Street, Room 418, HNES Building, Toronto, ON, Canada.

University of Ontario Institute of Technology, Faculty of Health Sciences, 2000 Simcoe Street North, Room 2043, Science Building, Oshawa, ON, Canada.

出版信息

Health Promot Int. 2019 Oct 1;34(5):1025-1031. doi: 10.1093/heapro/day058.

Abstract

There is little doubt that the implementation of a Basic Income Guarantee (BIG) in Canada and other liberal welfare states would alleviate some of the most egregious examples of absolute poverty that contribute to poor health such as lack of adequate food and shelter and inability to meet basic household and personal needs. BIG would likely improve the health of the most disadvantaged by moving them closer to the relative poverty line. Yet, advocacy for and implementation of BIG carries potential dangers. Since health improves with every step up the income ladder, simply moving people closer to the relative poverty line without providing additional universal benefits and supports common to most other developed nations would limit its health promotion potential. In addition, governing authorities in liberal political economies can use BIG to justify continuing imbalances in economic and political power that skews the distribution of the social determinants of health. In addition, implementation of BIG -- despite its more progressive advocates calls for maintaining or enhancing of existing social programs - can serve as justification for reducing or removing these programs, thereby threatening health.

摘要

毫无疑问,在加拿大和其他自由福利国家实施基本收入保障(BIG)将缓解一些导致健康状况不佳的最恶劣的绝对贫困例子,比如缺乏足够的食物和住所,以及无法满足基本的家庭和个人需求。BIG可能会通过让最弱势群体更接近相对贫困线来改善他们的健康状况。然而,对BIG的倡导和实施存在潜在风险。由于随着收入阶梯的每一步上升,健康状况都会改善,仅仅让人们更接近相对贫困线,而不提供大多数其他发达国家普遍享有的额外福利和支持,将限制其促进健康的潜力。此外,自由政治经济体中的执政当局可以利用BIG为经济和政治权力持续失衡辩护,这种失衡扭曲了健康的社会决定因素的分配。此外,尽管BIG更激进的倡导者呼吁维持或加强现有的社会项目,但BIG的实施可能成为削减或取消这些项目的理由,从而威胁到健康。

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