Next Steps on the Road to Basic Income in Canada

Canada has had recurring debates about guaranteed or basic income over several decades. This article outlines reasons for implementing basic income in the Canadian context—reducing poverty and inequality, addressing precarious employment, and building an ecologically sustainable economy. Recently there has been a strong renewal of interest in basic income in Canada. Expressions of interest have come from the Liberal federal government elected in 2015, from provincial governments, from political parties not in power, and from municipal governments. Support for basic income also is found in a growing range of prominent individuals and organizations. While basic income advocates are encouraged by recent developments, several large and complex questions remain on how this approach can be implemented in Canada. These questions encompass the specifics of design, delivery, funding, and political support. How can basic income build on existing income security programs and leave Canadians better off in the end? How can we ensure that basic income is not used as an excuse to cut vital services such health care, social housing, early childhood care and development, and social services for those with disabilities and other challenges? How can basic income be set in place in Canada, given its complicated federal-provincial nexus of responsibility for, delivery of, and funding for social programs? The article concludes with principles that might help guide the implementation of authentically universal, adequate, and feasible basic income architecture in Canada

Explaining Declining Social Assistance Participation Rates: A Longitudinal Analysis of Manitoba Administrative and Population Data

This paper extends analyses of the declining social assistance participation rate in Canada since the mid-1990s using rich Manitoba administrative data for the period since 1999. We examine trends in Manitoba to mid-2008, separately analyze the entry and continuation rates, and include for the first time information about the growing number of adults with a disability on social assistance. Our results show that the declining participation rate is due entirely to a declining entry rate and that the continuation rate has actually risen since 1999, mainly because of the dramatic growth in the number of adults with a disability on social assistance but also because of the rising duration of spells on assistance by those without a disability. Our results raise questions about the policy, pursued in all jurisdictions in Canada, that keeps social assistance benefits low to discourage welfare use.

Reconciling healthcare professional and patient perspectives in the development of disease activity and response criteria in connective tissue disease-related interstitial lung diseases

Interstitial lung diseases (ILD), including those related to connective tissue disease (CTD), and idiopathic pulmonary fibrosis (IPF) carry high morbidity and mortality. Great efforts are under way to develop and investigate meaningful treatments in the context of clinical trials. However, efforts have been challenged by a lack of validated outcome measures and by inconsistent use of measures in clinical trials. Lack of consensus has fragmented effective use of strategies in CTD-ILD and IPF, with a history of resultant difficulties in obtaining agency approval of treatment interventions. Until recently, the patient perspective to determine domains and outcome measures in CTD-ILD and IPF had never been applied. Efforts described here demonstrate unequivocally the value and influence of patient involvement on core set development. Regarding CTD-ILD, this is the first OMERACT working group to directly address a manifestation/comorbidity of a rheumatic disease (ILD) as well as a disease not considered rheumatic (IPF). The OMERACT 11 proceedings of the CTD-ILD Working Group describe the forward and lateral process to include both the medical and patient perspectives in the urgently needed identification of a core set of preliminary domains and outcome measures in CTD-ILD and IPF

Connective tissue disease related interstitial lung diseases and idiopathic pulmonary fibrosis: provisional core sets of domains and instruments for use in clinical trials.

RationaleClinical trial design in interstitial lung diseases (ILDs) has been hampered by lack of consensus on appropriate outcome measures for reliably assessing treatment response. In the setting of connective tissue diseases (CTDs), some measures of ILD disease activity and severity may be confounded by non-pulmonary comorbidities.MethodsThe Connective Tissue Disease associated Interstitial Lung Disease (CTD-ILD) working group of Outcome Measures in Rheumatology-a non-profit international organisation dedicated to consensus methodology in identification of outcome measures-conducted a series of investigations which included a Delphi process including >248 ILD medical experts as well as patient focus groups culminating in a nominal group panel of ILD experts and patients. The goal was to define and develop a consensus on the status of outcome measure candidates for use in randomised controlled trials in CTD-ILD and idiopathic pulmonary fibrosis (IPF).ResultsA core set comprising specific measures in the domains of lung physiology, lung imaging, survival, dyspnoea, cough and health-related quality of life is proposed as appropriate for consideration for use in a hypothetical 1-year multicentre clinical trial for either CTD-ILD or IPF. As many widely used instruments were found to lack full validation, an agenda for future research is proposed.ConclusionIdentification of consensus preliminary domains and instruments to measure them was attained and is a major advance anticipated to facilitate multicentre RCTs in the field

Connective tissue disease related interstitial lung diseases and idiopathic pulmonary fibrosis: provisional core sets of domains and instruments for use in clinical trials

Clinical trial design in interstitial lung diseases (ILDs) has been hampered by lack of consensus on appropriate outcome measures for reliably assessing treatment response. In the setting of connective tissue diseases (CTDs), some measures of ILD disease activity and severity may be confounded by non-pulmonary comorbidities.status: publishe

Connective tissue disease related interstitial lung diseases and idiopathic pulmonary fibrosis: provisional core sets of domains and instruments for use in clinical trials.

Identification of consensus preliminary domains and instruments to measure them was attained and is a major advance anticipated to facilitate multicentre RCTs in the field