By P. Robinson

While most of us have accessed our second vaccine dose and are returning to the pleasures of a “normal” life, there are people who will continue to live isolated, marginalized lives, with no hope for change. Why?  Because they are disabled in Ontario.

It doesn’t need to be this way.

Ontario has the opportunity to realize significant long-term savings in healthcare funding, improve health equity, reduce bureaucracy, and advance Reconciliation – all through the Ontario Disability Support Payment (ODSP).  By investing directly in Ontarians, a more productive, economically sound, and socially just province is possible.

While the pandemic puts unprecedented pressure on people and governments alike, the strain on Ontario’s healthcare system has been growing for many years.  With a proposed expenditure of 73.3 billion dollars in 2022-23 and accounting for 41% of program spending, it is the largest item in the Ontario budget. Costs continue to rise as the population ages, and post-pandemic, noncommunicable diseases – cardiovascular, diabetes, and kidney disease – will put increasing pressure on the health care system.  As well, mental health conditions create a high health burden, and the pandemic will only exacerbate this.

Providing an efficient, compassionate, and cost-effective health system is a significant challenge.  Decades of increasing funds for the health sector have not ended hospital capacity issues, wait times, and gaps in system coordination, and successive governments have failed to end ‘hallway medicine’.

At the same time, there is growing recognition of the desperate situation ODSP recipients are in, including media reports of some considering MAID (Medically Assistance in Dying). These Ontarians are without hope, believing that there is no other way out of the poverty they are living in. Some report having as little as $2.00 per day for food after paying rent. Recipients face the health detriments of deprived socioeconomic status: poor living conditions, lack of nutrition, stress, and low self-esteem.  These factors all contribute to poor health outcomes, therefore adding to the strain on the health care system.

By raising ODSP levels, Ontario could achieve two feats simultaneously:  lifting the disabled out of poverty and reducing healthcare costs. The current ODSP system keeps recipients impoverished, it de-incentivizes employment, and it is bureaucratic. A single person on ODSP receives $672 for basic needs and $497 for shelter for a total of $1,169 per month. There is no planned increase to ODSP for 2021, and Premier Ford stated “The best way to help people in Ontario Works or ODSP, if they’re healthy and they’re able to work, get them a job, help get them a job”.  However, even if the disabled recipient is able to work, earnings over $200 per month are punitively taxed at 50%.  And, considering Premier Ford’s distaste for “red-tape”, ODSP could be streamlined.  Currently, there are additional benefits requiring applications and with an appeal process.  Some require a doctor’s note, directly adding to health costs.

Providing a basic, living income benefit that allows the disabled to live above the poverty line has cross-sectoral benefits and savings. Despite the Conservative government cancelling the Universal Basic Income Pilot Project, McMaster University researchers documented a noticeable impact on the use of health services, with many of the survey respondents indicating less frequent visits to health practitioners and hospital emergency rooms.  As well, over 80 percent of basic income survey respondents reported a positive effect on their mental well-being.  This is an opportunity to target health outcomes upstream, rather than waiting for the costs to appear downstream, in the healthcare system. It also aligns with the Truth and Reconciliation Commission’s Calls to Action by targeting access to government services and opportunities for healthy lifestyles for Indigenous people in Ontario.

Reimagining ODSP could improve health and health equity and realize saving in the health care sectors. It will require political fortitude, as the savings may not be quantifiable in one election cycle.  However, the pandemic has made many more people aware of our fraying social safety net and those who are suffering amongst us.  For Ontario, making ODSP a living income would be a significant step in creating a more inclusive, just, and healthy Ontario – all achieved while realizing long-term savings in the health-care sector.

See our front page on Thursday for part-two of this series. 

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