A Conversation with Dr. Evelyn Forget

Dr. McGavock: [00:00:00] Welcome to the Emerging Scholar podcast. We hope you enjoy this series of great conversations with leading medical researchers that's designed for graduate students, medical trainees, residents, and fellows to help you on your journey towards your first scientific project. Welcome everyone to another special edition of the Emerging Scholar Podcast.

Dr. McGavock: Before we get started, I would like everyone here to meet our executive producer, Jared McKetiak. Welcome, Jared.

Jared McKetiak: Thanks, Jon.

Dr. McGavock: It is so nice to have you here. I can't thank you enough for the amazing work that you're doing for us here, but also for UMFM generally. It's an absolute pr- pleasure to be here.

Jared McKetiak: Well, hey, the pleasure is all mine. I appreciate the fact that you got the station involved in this project a long time [00:01:00] ago. I remember when we first met, you came down, you had an idea, and then this thing called COVID hit.

Jared McKetiak: Yeah.

Jared McKetiak: And the station reopened, the world reopened, and bam, there you were, right there at the door.

Jared McKetiak: So you had your kernel, your idea, and you never let it go, and I appreciate that, and always appreciate people who are coming through the station doors and doing interesting things, and I love working on this podcast, so.

Dr. McGavock: Awesome. Thank you so much. And without Jared and without UMFM, this nugget of an idea would never have made it to the airwaves, so I can't thank you enough.

Dr. McGavock: And honestly, during the week, this is one of the highlights of me coming down here.

Jared McKetiak: I love what I do, and I think that... You know, I read a quote one time that said, "Love what you do, and you can do it forever." And, you know, I don't know if I'm gonna do this forever, but, yeah, I don't see myself going anywhere in the very near future, easily anyways, so yeah.

Dr. McGavock: Yeah. That's great, and [00:02:00] that definitely applies to the world of research or clinical medicine. If you really, really love it, it doesn't feel like a job. So leading into this special edition of the Emerging Scholar, I sent you an email and said, "Our next guest is gonna be Dr. Evelyn Forget," and how did you feel about that?

Jared McKetiak: Well, so the name sounded, obviously sounded very familiar, and I had to just take a quick jog through the memory banks. And once I realized and confirmed that Dr. Evelyn Forget worked on the Mincome project, I was super excited. It is kind of like one of those tales that they tell, right? About this project that was established back in the 1970s, and it was, like, this idea of doing something that was for the betterment of all.

Jared McKetiak: And I'm a firm believer in things like universal [00:03:00] healthcare, and everybody should have the right to an education. Everybody should have the right to mental health supports. And so this study was so far, I think, ahead of its time, and every once in a while, it'll crop up again, and people will be like, "Well, you know, a universal income."

Jared McKetiak: It, it's something that, you know, my father-in-law, he was dyed in orange NDP. Yeah, yeah. Right? Yeah. And he talked about this project a lot, and it was just really, really neat to be able to hear Dr. Forget here. Also, Freakonomics guests-

Dr. McGavock: Yeah. ...

Jared McKetiak: you know? Like, it was the same, same sort of deal when, when we got to talk to, uh- Bapu Jena

Dr. McGavock: Bapu

Jared McKetiak: Jena, right? It's just like, "Oh, wow, you've, you've talked to Dubner." Yeah. Like it, and, like, Freakonomics is a b- is a big, big one for me. Um, also, I grew up in a small town [00:04:00] in, in southern Manitoba here, and I've been to Dauphin a- where the project took place, and so I understand the whole idea of growing up in a small town.

Jared McKetiak: There are limited options about what you can do and where you can go, and I w- went to high school with a lot of folks who didn't end up moving away ever. Yeah. Right? And a lot of them are still there. And so the idea of something like this going on in a rural Manitoba community was something that I related to, and I was just excited to hear what Dr.

Jared McKetiak: Forget had to say about the project because in a lot of ways, like- People know the sort of the end and the beginning, but they don't know a lot of the things ar- in and around it, right? They don't know. Some of it is, like, it's shrouded in... It's not [00:05:00] shrouded in secrecy. It's publicly available knowledge.

Jared McKetiak: But for somebody to go and dig into all of the information that was collected would be a momentous task.

Dr. McGavock: And so, without giving anything away, you touched on so many things that are really important about this interview because if you live in Manitoba, we're from Manitoba, this has such a Manitoba feel.

Dr. McGavock: The rebroadcast of her interview on Freakonomics was- Which

Jared McKetiak: was fairly recent ...

Dr. McGavock: it was released, like, the week we did the interview, which is in- insane. And that was in 2016. Mm-hmm. They were already forecasting how Mincome and AI might intersect, which is something that we do talk about. But also, I, like you, saw this as a social experiment to lift people up.

Jared McKetiak: Right.

Dr. McGavock: And that's actually not why they designed it in the first place. And for me, that was fascinating. So I hope that [00:06:00] those of you who are listening that have heard about the Mincome Experiment, that know about Dr. Forget, that are maybe as excited as we were when we found out she agreed to do this, will take some time, sit down, find a quiet space, make yourself a coffee or a tea, and just listen to this beautiful interview with Dr.

Dr. McGavock: Evelyn Forget on the Mincome Experiment that happened in Dauphin, Manitoba, in the 1970s.

Dr. McGavock: I cannot tell you how excited I am to have Dr. Evelyn Forget here with us talking about her career, the Mincome Experiment, and everything in between. Before we get started, thank you, Evelyn, for coming down to the studio here. It's rare that I get to interview someone in person, so I'm really honored. This morning, as I was leaving the house, there were mixed feelings.

Dr. McGavock: My wife was very jealous because you both were awarded a King Charles medal at the same time in a ceremony earlier this year, and she's like, "I can't believe I'm not gonna be there for the interview." But she was also super [00:07:00] excited to hear that. And then also more recently, I have a PhD student that's in community health sciences, and I think we had to write you a letter because you are serving in an administrative role.

Dr. McGavock: That was a while ago. Yes. Okay, that was last year maybe. But anyways, my sincerest honor to have you here. Perhaps you can give the audience a little bit of a background. I think most people would know you from the 2011 paper about the Minimum Income Experiment that happened in Dauphin, but maybe give us a little bit of a brief history of what got you to Winnipeg, Manitoba, and then what led to you thinking about and then diving into this really interesting experiment that happened in the '70s.

Dr. Forget: Well, thank you, Jon. I'm delighted to be here. When I get asked that question, what actually drove you to the Dauphin experiment and to looking at Mincome, this was really happening parallel to my life. I was an undergraduate student in the 1970s. I was at, in Toronto. I was at Glendon College, which is a small liberal arts college attached to York University.

Dr. McGavock: Okay.

Dr. Forget: I thought I was a psychology major. And York, like every other university, like the University of [00:08:00] Manitoba, has these distribution requirements, and so I had to find another social science course at that level that wasn't in my major, and the only thing that fit my timetable and fit the bus schedule was economics.

Dr. Forget: And so I signed up for this economics course, and I thought, "Yeah, great." I had no particular interest in economics. I didn't even really know what economics was at the time. Probably had something to do with inflation, which is a very interesting, and interest rates, that kind of thing.

Dr. McGavock: Which was a hot topic.

Dr. Forget: Because this was 1975. Um, so- Gas lines ... yeah, right in the middle of the oil price shocks- Right ... of the period, and I thought, "Do I want to do this for a year?" So I signed up for the course, and I'm sitting there, like most undergraduate students, you- trying to get through this course, and I had this wonderful economics professor, and one day he came in Quite excited about this little project he'd heard about that was taking place.

Dr. Forget: Now remember, this is Toronto. It was taking place way out west somewhere. And it was gonna revolutionize, to his mind, it was gonna revolutionize the way we [00:09:00] delivered income assistance in Canada. And so we talked about this project, which was called Mincome, and he explained a little bit about how economists were actually experimenting on a large scale with a different way of delivering income assistance.

Dr. Forget: And the idea behind a basic income, of course, is that everybody, all families are s- guaranteed a sufficient income to live with a little bit of dignity.

Jared McKetiak: Right.

Dr. Forget: But the nice thing about basic income as opposed to standard welfare of the time, is that there are fewer gaps in the system and there's no welfare wall.

Dr. Forget: That is, as your income from other sources increases, the benefit you receive declines, but it declines very, very gradually.

Dr. McGavock: Mm-hmm.

Dr. Forget: So it's a different way of delivering support, and, uh, hopefully it would do away with a little bit of the stigma of receiving income assistance because a lot of the money would go to people who were in the workforce, who were working.

Dr. Forget: So there was no clear distinction between people who were collecting income assistance and people who were working.

Jared McKetiak: Hmm.

Dr. Forget: So this [00:10:00] project was taking place way out west somewhere, and it was sort of a fascinating topic that was happening in 1975, and I perked up my ears at the time because I was in psychology and like a lot of people, I thought, "Well, you know, I guess I kinda wanna help people."

Dr. Forget: It never occurred to me that public policy is actually a way to influence a lot of people at the same time. It certainly didn't occur to me that economists engaged in experiments. I followed this through my undergraduate career. The Mincome Experiment took place between 1974 and 1978, so it was almost parallel with my undergraduate years.

Dr. Forget: And I, in fact, changed my major at least in part because of that experiment. Oh, wow. It was, it was quite exciting at the time. And I was part of a cohort of students. Remember, it's 1975. We thought, "You know, we're gonna take those tools of economics and we're gonna use them to make people's lives better instead of just to make a lot of money."

Dr. Forget: Yeah, that didn't last very long in the profession, but- Right. Right ... at the time there were a lot of people- Yeah, yeah, yeah ... thinking that way. Yeah.

Dr. McGavock: Yeah. And so- Good economics department in Canada- ... [00:11:00] is focused on public policy. That's right.

Dr. Forget: So anyway, I went off to graduate school and things changed a little bit in graduate school, and I got distracted in doing a lot of other kinds of things.

Dr. Forget: I actually worked as a theoretical economist for quite a long period of time looking at the history and philosophy of the field. And I got a job in Winnipeg, and when I came to Winnipeg, I discovered that way out west was in fact Winnipeg. Right in the middle. And in fact, some of the people at the University of Manitoba I was working with in the economics department had been involved in that old experiment.

Dr. McGavock: Oh, really?

Dr. Forget: So this was always part of my consciousness, but it was not something I was working with until many years later a- and when I transferred to community health sciences. And when I started working in community health sciences, I was working on structural determinants of health, and of course, income is the big driver of all kinds of health outcomes.

Dr. Forget: And I was very frustrated because there's a lot of correlational evidence out there- Mm ... that links income to health outcomes, but there's not a lot of, of causal evidence. And so the question [00:12:00] remains, if you actually do something about poverty, if you address poverty, do you actually impr- improve people's health outcomes?

Dr. Forget: And it just twigged in my mind that we had this old experiment had taken place here in Manitoba, and so I went looking for the data, which I gotta tell you was not a minor thing.

Dr. McGavock: Yeah.

Dr. Forget: But I went looking for the data, and I wondered if they'd collected any of the health outcomes. It was almost entirely focused on work effort.

Dr. Forget: Would people continue to work if you gave them money?

Dr. McGavock: Mm-hmm.

Dr. Forget: But I eventually tracked the data down to the National Archives, and that's when my project began.

Dr. McGavock: I do wanna ask you, 'cause I've never heard or read about what you actually found inside the archives before you were linking the data to MCHP.

Dr. McGavock: Right. But that was the thing that fascinated me the most, and I pulled up a paper in the Free Press from 1975 about what the experiment was really designed for, and it- Mm-hmm ... the title was An Experiment to Test the Protestant Work Ethic. That's right. Which I guess you could write that in the paper back in the day, but it [00:13:00] was sense of- We think that if we give enough money to individuals, which many of us saw with the CERB during COVID, and maybe we can come back to that later- Mm-hmm

Dr. McGavock: that they would just stop working, and that the labor force would diminish, and that would kill the economy. And so these experiments were really designed to say, "What is it gonna be like for us to implement this, and are we actually gonna lose a lot of labor force production?"

Dr. Forget: Yep, exactly right. That was the big fear at the time.

Dr. McGavock: And what was the political climate like? Why was that the driving force?

Dr. Forget: Well, you know, it's interesting, but there were a lot of things happening, and really you can go back to the end of the Second World War, really right across North America. A lot of American soldiers in particular came back and went back to their hometowns and discovered that in this land of plenty, because there was this huge economic boom after the Second World War.

Dr. Forget: Yeah. But in this land of plenty, there were a lot of people living without plenty. There was a lot of poverty. And so there was sort of a rediscovery in the 1960s, really, in the US of the prevalence of [00:14:00] poverty in particular pockets in the US, in Appalachia, in inner cities, and so on. And that led to a lot of focus.

Dr. Forget: I mean, if you're a wealthy country, you should be able to do something about poverty in your midst. And so really there were actually five of these experiments that took place in the 1960s and 1970s. Four of them were in the US. We got our Canadian experiment because being Canadians, American data couldn't possibly be relevant to us.

Dr. Forget: Right. So we insisted on our own. But politically, there was a big push, and this was a period, again, if you think back to that, this was the period of the war on poverty in the US. And so there was a real focus as we were moving into the 1970s that we could really do something about this. We shouldn't have people living like this in North America.

Dr. Forget: And that, of course, was before all of the terrible things that happened economically in the 1970s. So the experiments were designed and built during a period when people really believed that there were the resources to do something, to make some change. Mm-hmm. And of course, as the experiments started to unfold in both Canada and the US, they were [00:15:00] dealing with oil price shocks and inflation and all kinds of terrible things that really distracted people's attention and distracted the attention of policymakers nationally.

Dr. McGavock: Mm-hmm.

Dr. Forget: Got them to focus on other things. And so I think that's why they lost momentum during that period.

Dr. McGavock: Reading your paper, the two names that were in charge of the four experiments in the US that were spearheading it made me chuckle. Dick Cheney and Donald Rumsfeld.

Dr. Forget: It's amazing. I'm going back and reading- That's awesome

Dr. Forget: and thinking, "Holy cow. Wait, wait a minute." And then you forget that these names have been around for a while.

Dr. McGavock: Yeah. I could not believe it. The other thing that came out that I found really interesting that I think people touched on early, and this is all before we get into the health outcome side, was the amount of waste happening in the government with multiple opportunities for people to access income through the welfare system- Yeah

Dr. McGavock: through social assistance, through age-related or retirement. And part of the experiment, I guess, too, was to see is there any cost savings on the government side.

Dr. Forget: Yeah. One of the big economic proponents during the period was Milton Friedman. Milton [00:16:00] Friedman was the - Yeah. Right. That was in your favorite reading

Dr. Forget: was the great charger for basic income.

Dr. McGavock: So Manitoba had our first one.

Dr. Forget: We did.

Dr. McGavock: We did. And in reading the history of it, I think it was Ron H- Hikel? Hikel. Mm-hmm. Ron Hikel, who was-

Dr. Forget: Yeah ...

Dr. McGavock: who was the economist who was here in Manitoba. Yeah. And we often focus on the Dauphin side.

Dr. Forget: Yeah.

Dr. McGavock: We do. Right? But the M is for...

Dr. McGavock: I thought, I always thought it was for minimum income. It's, it's- Oh, it could also be Manitoba.

Dr. Forget: No, yeah, no, it's minimum income.

Dr. McGavock: Okay. I'll put the M for Manitoba in this. Yeah. So the M for Manitoba was, it wasn't just Dauphin. No. There was also an RCT in Winnipeg, so maybe, can you just walk us through what the overall design of this $17- Sure

Dr. McGavock: million experiment looked like?

Dr. Forget: Sure. I should say, first of all, that economists didn't do randomized control trials. This was really the very first time. All of the four US experiments were RCTs.

Dr. McGavock: Okay.

Dr. Forget: And in Canada, the Winnipeg sample was set up as an RCT.

Dr. McGavock: Mm-hmm.

Dr. Forget: And Dauphin was a little bit different, and that's really why I focused on it, and I can talk about that in a second.

Dr. Forget: Dauphin was a saturation site. Mm. And what that [00:17:00] means is that everybody in Dauphin was a participant in the experiment. Everybody received the same promise. That is, they didn't all get the money, but if their income fell below a specified threshold, they'd get support. And that made things quite different.

Dr. Forget: All of the other experiments in Winnipeg, for example, the researchers would show up in town and they'd find all of the people who were eligible for the experiment. They'd take a very small proportion of them and give them a basic income, and the others would serve as the control group. And the idea is that at the end of the experiment, you could look at the outcomes and see what impact the basic income had relative to whatever programs the others were relying on.

Dr. Forget: Yeah. So the existing system Now in Dauphin, because everybody got the promise, there was no control group.

Dr. McGavock: Mm-hmm.

Dr. Forget: But the idea of doing a saturation site was that there are certain social effects that tr- transcends individuals.

Dr. McGavock: Right. Yeah.

Dr. Forget: So from an economic point of view, they were looking at things like if everybody in town has more money, that's gonna have an impact on businesses, for example.

Dr. Forget: Small businesses will be able to [00:18:00] survive.

Dr. McGavock: Mm-hmm.

Dr. Forget: Things might change, and so they were trying to pick up some of those changes. But because they didn't have a control group, there were a couple of other little communities near Dauphin that were serving as the control, so people living there.

Dr. McGavock: Okay.

Dr. Forget: It's kind of an awkward way of doing things, and I did things a little bit differently when I moved in.

Dr. McGavock: Mm-hmm. I think the other advantage, at least from my external viewing of this too, was that if you live in a community where you know everyone is gonna meet that minimum 5,000. Yeah. That was one of the questions I was gonna ask you and I forgot about earlier, is it was 5,000, and it was a negative income tax.

Dr. Forget: That's right.

Dr. McGavock: And so maybe you can a- answer two questions in a second. What's a negative income tax? Yeah, what's a neg- And why 5,000? Why 5,000? What's negative income tax? But I do feel like there would be a potential greater impact when the whole- Yeah ... community gets it, right? And this is the concept of universal basic income that- Yeah

Dr. McGavock: if you lift all boats, right? Yeah. And everyone's there, all those inequities-

Dr. Forget: That was the focus of my work. That's why I did it the way I did.

Dr. McGavock: Right.

Dr. Forget: First of all, why the $5,000? They set the rate just barely above [00:19:00] what, uh, the family would get on social assistance in Manitoba.

Dr. McGavock: Okay.

Dr. Forget: It was a little bit above because if it were lower, obviously nobody would take it.

Dr. Forget: So the, the guarantee- Right. ... had to be high enough to encourage people to register in the experiment.

Dr. McGavock: Yeah.

Dr. Forget: And those rates were typically set as a proportion of the poverty, what was being perceived as the poverty line at the time, okay? So if, if you think about in terms of dollars, I think it translates into something like 28, $29,000.

Dr. McGavock: Today.

Dr. Forget: Okay, so that's why the... Oh, and what's a negative income tax?

Dr. McGavock: Yes.

Dr. Forget: Okay. Well, I did sort of explain that. So there's a basic guarantee of about $5,000, I think it was, for a family of four, a basic guarantee of $5,000. But it was available to you whether you were working or out of the labor force. So if you were out there working and you made $1,000, that's not enough to support yourself.

Dr. Forget: It's well under the 5,000. Mm-hmm. But under the welfare of the period, making $1,000 would disqualify you for welfare, so you'd be much worse off.

Dr. McGavock: So that's the working poor?

Dr. Forget: The working poor.

Dr. McGavock: Right.

Dr. Forget: So the idea here is that if you [00:20:00] go out and you make $1,000, well, you won't get the full $5,000. We'll reduce it, but we're gonna reduce it by a proportion of what you earned.

Dr. Forget: So if you earned $1,000, we'll still give you $4,500.

Dr. McGavock: Right.

Dr. Forget: So you go out and you work, and you make $1,000. You get 4,500, and well, now you're better off. Yes. So there's always an incentive. You're always better off working. And that was the idea. That was what attracted Milton Friedman and all of those people.

Dr. Forget: You're gonna eliminate the work disincentive that's attached to welfare. That was the focus at the time.

Dr. McGavock: Right. And what is the rationale for thinking, and what evidence did people have thinking that if we just pay everyone $5,500, they're gonna leave the workforce? They don't wanna make 10, they don't wanna make 15.

Dr. McGavock: W- where did that fear come from?

Dr. Forget: Well, it's the belief that if you liked working, we wouldn't pay you. What do you think we pay you for?

Dr. McGavock: That's-

Dr. Forget: No, it, it, frankly, it's a basic distrust. And it's interesting because it's a distrust we have of people at the bottom end- [00:21:00] Yeah ... of the income distribution, not the top end.

Dr. McGavock: No, it's-

Dr. Forget: Nobody says- ...

Dr. McGavock: classism ...

Dr. Forget: you know, nobody says it when we talk about docs, for example, about physicians. Nobody talks about that.

Dr. McGavock: No.

Dr. Forget: It's purely people living on minimum wage or something like minimum wage. We're worried about giving them a dollar or giving them two dollars and- Mm-hmm ... discouraging them from work.

Dr. Forget: Mm-hmm. And I think it's actually very, very longstanding. I've got a little book in the works right now that's coming out probably next fall from UBC Press. My title is, my working title is The Undeserving: Rethinking Who Counts and Why.

Dr. McGavock: Oh, wow.

Dr. Forget: So how do we find these people and why do we label them as undeserving?

Dr. Forget: Because that's what it is. It's a belief

Dr. McGavock: that- Mm-hmm ...

Dr. Forget: we're just not going to trust them to work. There's not a lot of evidence for that, but there is some. I mean, if you set up your social programs badly, if you set them up in particular ways, you actually make people a lot worse off for working. So my example a minute ago was one of them.

Jared McKetiak: Well,

Dr. Forget: exactly. Okay, if I've got kids to feed and you're gonna give me $5,000- Right ... [00:22:00] why would I go out and risk that $5,000 with a job that might not last more than two months? And you're gonna take it away from me, so you're actually setting up disincentives at the time. So we're- I- ... trying with this to make it better

Dr. McGavock: have had that experience. I've had people ask me, like, "Am I gonna lose my- Exactly. So- ... benefits for my children?" Like, if... I'm like, "We're... I don't want that to happen." We are paying a livable wage, but even- Yeah ... there, it's gonna take away income that is absolutely- Yeah ... essential for that family to thrive.

Dr. Forget: And it's even worse if you've got benefits attached, right?

Dr. Forget: So i- if you're collecting social assistance and you've got all kinds of social benefits that are attached to that- Right, right ... like your dentist visits, for example, or medication, before pharmacare, medication and so on.

Dr. McGavock: Yeah.

Dr. Forget: You lose all of that, so you're actually much, much worse off. So really, what we're doing with Mincome, it's, partly it's not trusting people, but partly it's trying to ensure y- that you're not creating policies that cause more trouble than-

Dr. McGavock: Right,

Dr. Forget: right

Dr. Forget: unintended consequences.

Dr. McGavock: Yeah, and I didn't appreciate that [00:23:00] when I was first reading up on this. And actually, working at the Children's Hospital in Winnipeg and seeing the lives of children living with chronic disease- Mm-hmm ... and families who are trying to support a kid with a chronic disease-

Dr. Forget: Mm-hmm ...

Dr. McGavock: the first thing that comes to my mind is a universal basic income.

Dr. Forget: They- Well, you might be interested. There's actually a group of physicians at Harvard right now who are beginning a little trial-

Dr. McGavock: Oh ...

Dr. Forget: in New York and in Boston for families w- facing pediatric cancer.

Dr. McGavock: Oh, okay.

Dr. Forget: And it's exactly that. If you think about all of the costs that aren't picked up-

Dr. McGavock: Mm-hmm ...

Dr. Forget: via social programs, it's hard for families.

Dr. Forget: You're giving up income. There's so much caregiving required within the family.

Dr. McGavock: And the stigma to apply for programs- Exactly ... like- Exactly ... you know, Noralou Roos is, is a champion for this, like, trying to-

Dr. Forget: Mm-hmm ...

Dr. McGavock: ensure that, that families get access to these benefits. But one of the things when I talk to families is the stigma of having to apply, having to make proof, having to go through the system.

Dr. Forget: Having to demonstrate that you actually are in need.

Dr. McGavock: Yes. So I can't believe Milton Friedman. I [00:24:00] honestly can't believe Milton Friedman came up with this, but the more I read about it, the better it is. Now, one of the reasons I ask about that question of, like, our concern of the people who are gonna take advantage of the system, is that it seemed to drive what...

Dr. McGavock: I always thought these experiments were about, like, family wellbeing. Like, I thought the main outcomes were gonna be, like, families thriving- Yeah ... education, food security.

Dr. Forget: Well, they're, they're being conducted by economists.

Dr. McGavock: They're economists, so-

Dr. Forget: Yeah ...

Dr. McGavock: they're actually designed as non-inferiority trials, right?

Dr. McGavock: Yeah. It's like, "Here's our system. Our system we know is broken, so let's come up with another-"

Dr. Forget: Yeah ... "

Dr. McGavock: possibility, and if we get the same result as we're getting-"

Dr. Forget: Mm-hmm ...

Dr. McGavock: not uplifting families, just making the job force There, there isn't a change in the labor force. Mm-hmm. And as long as there's no change in labor force, it was successful.

Dr. Forget: Yep.

Dr. McGavock: That was it. I was like- That was

Dr. Forget: it ...

Dr. McGavock: come on, goodness, this is it.

Dr. Forget: Yeah.

Dr. McGavock: So everyone focused on that.

Dr. Forget: Yep.

Dr. McGavock: And this is, I think, where your work came in, right?

Dr. Forget: Well, I went looking through those box- There were like 1,800 boxes, right? Because you think about the way data [00:25:00] was collected in the 1970s . Right.

Dr. McGavock: Right? Right.

Dr. Forget: So there were mimeographs and old computer cards and, you know- Yeah ... data cards and so on.

Dr. McGavock: So I, I was looking through the Free Press archives. Yeah. And I put in MINCOME or I put in Dauphin experiment, and I would get thousands of hits, and they were all for data entry jobs.

Dr. Forget: Yeah, exactly. It was a great job creator.

Dr. McGavock: Number of job opportunities.

Dr. Forget: Huge numbers of people came to do those kinds of things. Yes. And it also created a lot of jobs for graduates from the University of Manitoba and the University of Winnipeg. Yeah. If you think, ag- Remember, this is 1975, 1976, and you think a- about the 1960s sort of came to Canada in the mid-1970s.

Dr. Forget: Mm-hmm. Yeah. So if you think about the kinds of things that were happening in Winnipeg-

Dr. McGavock: Yeah ...

Dr. Forget: and these kids were being shipped up to Dauphin, and Dauphin is a whole lot different from Winnipeg. So it was a real eye-opener, I think, for a lot of kids. First of all, the interaction with same age peers in Dauphin was, I think, an interesting one for many people.

Dr. McGavock: Yep.

Dr. Forget: A lot of interviewers came into contact with rural poverty for the first time. Right. And the recognition of how people were actually living- [00:26:00] Mm ... in the small towns in Manitoba during the period. But yeah, there were a lot of people working for that experiment.

Dr. McGavock: Some hard, hard lives of farmers.

Dr. Forget: And, you know, uh, there's a great story, and actually it was Ron Hikel who talked about the story.

Dr. Forget: Going into a farmhouse and being, at the t- You know, you're sort of a nerd at that point. You know you're gonna walk in and see.

Dr. McGavock: Yep.

Dr. Forget: And he said he walked in and he saw this marvelous collection of records. Opera.

Dr. McGavock: Oh.

Dr. Forget: Opera. Just around the whole room, this incredible collection of opera records. Yeah. And they had this long conversation about opera, and you know, Saturday at the Opera on CBC- Oh, wow

Dr. Forget: everything would stop. So yeah, there are all kinds of cool stories that come out of that. We

Dr. McGavock: should do another podcast- ... on just the stories that came out. Yeah. So again, what was fascinating to me is that- Yeah ... no one had really systematically done s- Yeah ... health outcomes to say, "Did this-" Yeah ... "actually improve health?"

Dr. McGavock: So-

Dr. Forget: Yep ...

Dr. McGavock: you're now, you were in the faculty of economics.

Dr. Forget: Yep.

Dr. McGavock: Then you moved to MCHP- Yep ... Community Health Sciences.

Dr. Forget: Yep.

Dr. McGavock: Okay.

Dr. Forget: I remembered the data, and one of the reasons I focused on Dauphin [00:27:00] was because it was a saturation site. And so I could find all of the people who were actually living in Dauphin during the period and who were in principle eligible for the experiment, and I could trace them.

Dr. McGavock: In those boxes?

Dr. Forget: In the b- No. Well, they're, they're in the boxes. It's, yeah. But I looked at those 1,800 boxes and thought, you know, my life is finite. I don't have time to do that. Right. But I could find a data repository. In the Manitoba Data Repository, I could find the people who were living in Dauphin during the period.

Dr. Forget: Right,

Dr. McGavock: right, right.

Dr. Forget: Because of that, I could actually find out what their health was like during the period, you know, their families. I could trace them over time, and I could also set up a nice little control group in the original experiment. Because I had it all, I could just use propensity score matching and find out people who were similar to the people in Dauphin.

Dr. Forget: So I was trying to find four-to-one matches- Yeah ... to set up a control group And I couldn't get four, I got three. I- I got three to one matches- Yeah ... of people living in similar towns, same age, same sex, similar kinds of backgrounds, similar kinds of income- Yeah ... to see what the differences were.

Dr. McGavock: So [00:28:00] with the propensity score match, what you're trying to do is find the counterfactual or the- That's

Dr. Forget: right.

Dr. McGavock: That's right ... the person who looks or is so similar-

Dr. Forget: Yeah ...

Dr. McGavock: to the person- Yeah ... or family that did receive the Mincome- Yeah ... or participate in the experiment.

Dr. Forget: And- Exactly. So if I had a 21-year-old woman, for example, I'd go out and find three other 21-year-old women living in town, similar kinds of places.

Dr. McGavock: And we'll go through a little bit the paper that showed how well that propensity score match.

Dr. McGavock: But before we get into that, in season two we are gonna talk about administrative health data, but for those that don't know, what was in MCHP that allowed you to know, one, like they lived in Dauphin, two, they lived there during that time, and then three, whether or not they went to see a physician or went to the hospital, which were the eventual- Yeah

Dr. McGavock: health outcomes which we can talk about in a second.

Dr. Forget: Yeah. Okay. Well, that data, the health data certainly goes back to really the beginning of universal healthcare-

Dr. McGavock: Right ...

Dr. Forget: in Manitoba, so 1971 I can get the data. Now the- That was- ... because the experiment took place in [00:29:00] '74.

Dr. McGavock: That was amazing. Amazing timing.

Dr. Forget: Yeah.

Dr. Forget: I was very fortunate. If you live in Manitoba, if you've had any interaction with the healthcare system, you know, if physicians are gonna get paid, they're gonna fill in a certain amount of paperwork that's gonna give us quite a lot of information about what you were there for and what was happening to you.

Dr. McGavock: Right.

Dr. Forget: The data's all anonymized, of course, so I couldn't find people in it.

Dr. McGavock: Mm-hmm.

Dr. Forget: But I do know where people live. I know postal code of residence. I know quite a lot about them. And once I know a postal code, I can actually use the census to find out a lot about the neighborhood, right?

Dr. McGavock: Yes.

Dr. Forget: So I can find people living in similar kinds of communities with similar income profiles and, you know, similar, you know, farming focuses and so on.

Dr. McGavock: Yep.

Dr. Forget: So I can do that. The data at the time, the hospitalization data was very good. The physician data was pretty good, and there wasn't a lot else during that period.

Dr. McGavock: Right.

Dr. Forget: And of course, over time the administrative data has gotten much, much richer. Mm-hmm. We're gonna talk about it. You'll be talking about all kinds of things like [00:30:00] pharmaceuticals and-

Dr. McGavock: Education

Dr. Forget: educa- education and social assistance. Social assistance. Incredible. But that was not available in the 1970s.

Dr. McGavock: Yeah. So where did your interest... Like, when did you ask yourself, "Okay, correlation, correlation, correlation. We need an experiment. I'm an economist. I do experiments"? I still can't believe how few health researchers-

Dr. Forget: Yeah

Dr. McGavock: are embracing this natural experiment context, right? Yeah. So-

Dr. Forget: Yeah ...

Dr. McGavock: what kind of drove you to say, "I am gonna tackle this with a natural experiment"?

Dr. Forget: I don't even know. It was just, uh, partly it was just, I wonder if I'll find anything. Yeah. That's kind of a neat story, which was important because if you need funding to use the administrative data, you need to be able to tell a good story that makes somebody say, "Oh, cool.

Dr. Forget: I wonder how that worked." Did you get funding to

Dr. McGavock: do it?

Dr. Forget: Well, no. It was such a long shot, and I, I was talking to Leslie Roos about the data, and he was very dismissive. He didn't think I'd be able

Dr. McGavock: to do anything And people were... I mean, you know- Sometimes that's a good sign.

Dr. Forget: Well, maybe.

Dr. McGavock: At least for me, it motivates me to [00:31:00] do it when someone's like- Mm-hmm

Dr. McGavock: "You'll never find anything."

Dr. Forget: Yeah. Uh, so I mean, it was kind of a long shot really. Mm-hmm. Um, I mean, I'm utterly convinced that more money makes people healthier.

Dr. McGavock: Yeah, me too.

Dr. Forget: And I mean, we see that in lots of ways. People do routinely now a- ask questions when they do basic income experiments about health, but few of them have the kind of resources that we have to actually look at it.

Dr. Forget: We in Manitoba- Yeah ... Manitoba, that administrative data is really a godsend for it. And

Dr. McGavock: no one could do this in the US?

Dr. Forget: No.

Dr. McGavock: No one could do this in BC- No ... or Saskatchewan, so.

Dr. Forget: What you need is a- Right ... single database that brings it all together, not a whole lot of disjointed databases. Because otherwise you're relying on people to, first of all, remember, were you in the hospital?

Dr. Forget: What were you there for? Yeah. And how long were you there?

Dr. McGavock: Yeah.

Dr. Forget: And they don't. Um- Yeah ... what's your health like? Has your health improved? And a lot of that is happening. But we actually have hard data to look at it.

Dr. McGavock: And we have data on everyone. So that's really- Enjoy ... really unique. Like reading a few other studies while I was doing research for this.

Dr. McGavock: Actually, [00:32:00] a few of the studies that came up that I hadn't really linked to basic income were studies of Native American youth-

Dr. Forget: Yep ...

Dr. McGavock: in communities where a casino has come in.

Dr. Forget: Oh, yeah. Cherokee.

Dr. McGavock: Cherokee. Yeah. Yeah. And so, like one study, I couldn't believe it. If you were in a younger cohort when the casino came in, your cash payment at age 18 was like $35,000.

Dr. Forget: Nice.

Dr. McGavock: Yeah. And so in that case, they were fortunate enough to be enrolled in a cohort- Mm ... study, so it wasn't every child. But every child did get something in the intervention, so if you had a decent enough sample size, you could work with that.

Dr. Forget: Everybody.

Dr. McGavock: Yeah. You had the whole town, and then you had three people for every person- That's right

Dr. McGavock: in the whole town. They were matched on age, and they were matched on... What was the third thing in that score?

Dr. Forget: Uh, age, sex, family type.

Dr. McGavock: Family type, right.

Dr. Forget: Uh, female led.

Dr. McGavock: Yep.

Dr. Forget: Female led, lone parent families I had a little marker for. And, you know, all of the sort of standard things that you'd think- Mm-hmm ... you can find.

Dr. Forget: Anything really I could get out of the data.

Dr. McGavock: And if keen researchers like myself go through the appendix of your paper- Yes ... you actually mapped [00:33:00] it out.

Dr. Forget: Yes.

Dr. McGavock: Um-

Dr. Forget: Okay.

Dr. McGavock: The, like in the appendix, you went through all the potential confounders or all the- Yeah ... potential other factors- Yeah ... that could mediate it.

Dr. Forget: I spent a lot of time on newspapers during the period and talking to people, trying to figure out if anything else had happened in Dauphin that might have res- affected these results. Yeah.

Dr. McGavock: Yeah,

Dr. Forget: trying to rule it out.

Dr. McGavock: And while you go th- So the only thing that stuck out was Ukrainian ancestry. Yeah. Which I guess you get that from the census, right?

Dr. McGavock: You-

Dr. Forget: Yeah. Particularly since we're talking about third generation by that point.

Dr. McGavock: Right. Right. So amazingly, though, everything like down the line was almost exactly. So the neighborhoods, the people looked ex- that you had as controls looked exactly like the people- Yeah ... in Dauphin, which is like-

Dr. Forget: Yeah ...

Dr. McGavock: you know, you couldn't ask for anything better.

Dr. Forget: Well, that's a good methodological question. I was trying for four controls for one subject, just, you know, because typically that generates a good trial.

Dr. McGavock: Mm-hmm.

Dr. Forget: And so I got to three, and I had three very good controls. If you go to a fourth control, the fourth control is not very good.

Dr. McGavock: [00:34:00] Oh.

Dr. Forget: And so you're making this call.

Dr. Forget: Do I stick with three good ones, or do I muddle up my-

Dr. McGavock: Right ...

Dr. Forget: control group? So I stuck with three.

Dr. McGavock: Right.

Dr. Forget: Yeah.

Dr. McGavock: And that was like- Happy

Dr. Forget: with it ...

Dr. McGavock: your caliper calibration. Get that fourth one who just falls a little outside that.

Dr. Forget: Yeah.

Dr. McGavock: And then how many people are in the Dauphin study?

Dr. Forget: It was about 10,000

Dr. McGavock: people.

Dr. McGavock: You had 10,000 in the intervention. Yeah. About 30,000 in the control.

Dr. Forget: Yeah.

Dr. McGavock: Massive study. Large sample size. Like beautiful design in that you got the whole group, and so what did you find?

Dr. Forget: 8.5% reduction in hospitalization overall. Which is extraordinary

Dr. McGavock: Unheard of

Dr. Forget: Yeah

Dr. McGavock: Unheard of. Right

Dr. Forget: I, I'm working on similar kinds of things now in a slightly more refined way and finding similar kinds of big effects for cash payments

Dr. McGavock: And so the rate of hospitalization was a little bit different in the Dauphin group compared to the controls in the years prior to-

Dr. Forget: That's right

Dr. McGavock: 1975

Dr. Forget: Yeah

Dr. McGavock: And then by the end of 1979, they had merged Yeah And Dauphin actually, I think, was a little bit lower

Dr. Forget: That's right ...

Dr. McGavock: than control sites

Dr. Forget: Yeah

Dr. McGavock: A complete [00:35:00] shift in the

Dr. Forget: community There was a huge, huge difference in terms of hospitalizations. And I'm prepared to bet these are ambulatory care sensitive conditions

Dr. McGavock: Okay

Dr. Forget: These are conditions that probably shouldn't have happened if people had the resources to care for themselves- Right

Dr. Forget: and to go to a doctor or to engage in preventive medicine

Dr. McGavock: Right. And had stability in the household and- Yeah ... just

Dr. Forget: good- All of, all of the things- ... base ... to take care of yourself- Exactly ... and take care of your kids

Dr. McGavock: So in terms of 8%, as an economist, what are you looking for when you have an experiment? Like, what is a good

Dr. Forget: effect size?

Dr. Forget: Well, I'm looking for statistically significant Right. So I mean, I was delighted, you know, it was 8.5%. I mean, that's... And that's huge Yeah That's really large. You know, with 10,000 people, you don't get that many hospitalizations in a year. But still- Huge. Huge ... it's a huge impact

Dr. McGavock: So if we're doing a causal diagram, and this is in adults, so, um- Yeah

Dr. McGavock: it's a two-part question. Like, if I was gonna draw a line from- Guaranteed annual income and improved health.

Dr. Forget: Mm-hmm.

Dr. McGavock: And then we are gonna draw a couple other lines to say, what would you explain? How do you get from one to the other? [00:36:00] What's happening in that household? And there is some data, like you saw that...

Dr. McGavock: So there was a reduction in labor force- Yeah ... participation.

Dr. Forget: There was, and yeah.

Dr. McGavock: Because?

Dr. Forget: Well, this was before parental leave, right? I think maternity leave at the time was four weeks, and there were a whole lot of women who thought, "You know, really, this is a rather miserly maternity leave, and I'm just gonna use some of the Mincome money to buy myself a longer maternity leave."

Dr. McGavock: And take care of my kids.

Dr. Forget: Take care of my kids.

Dr. McGavock: Another fascinating part of the Free Press articles I was pulling, the average work week was somewhere between 48 and 70 hours a week. Amazing. So right, you are gonna be at work 50 hours a week- Yeah ... or you're gonna be with your child- Yeah ... through the first few months.

Dr. McGavock: So there's a huge one,

Dr. Forget: right? Well, that's not, that's not, that's not quite fair because many of the women were working part-time.

Dr. McGavock: Part-time, okay.

Dr. Forget: Yeah. It's the men who are working extraordinarily long hours.

Dr. McGavock: Okay, so then some of the other workforce loss, and they talk about this in the paper, they interview a young guy-

Dr. Forget: Mm-hmm

Dr. McGavock: who said, "Yeah, I'm gonna leave my job so that I can-"

Dr. Forget: Yeah, go to school.

Dr. McGavock: Go... It was an opportunity for you, especially, I guess- Yeah ... in this agricultural town, [00:37:00] right? Where you were, you were gonna maybe leave high school early, not graduate, and then- Well, the

Dr. Forget: schooling, the schooling, actually, I looked at that as part of the paper.

Dr. Forget: I couldn't do it with the Manitoba center data because it wasn't linked.

Dr. McGavock: Yeah.

Dr. Forget: But I was able to... I mean, there aren't very many high schools

Dr. McGavock: Yeah ...

Dr. Forget: in a little town, right? It's

Dr. McGavock: true, yeah.

Dr. Forget: So I was able to look at the graduation rates, and we also saw a rather nice little bump in high school completion rates-

Dr. McGavock: Mm-hmm

Dr. Forget: during the period of the experiment. And in fact, one year with, there were more kids graduating from grade 12 than had been in grade 11 the year before.

Dr. McGavock: Right

Dr. Forget: on. Right? Yeah. So in fact, people were coming back to school-

Dr. McGavock: Yeah ...

Dr. Forget: uh, to finish and to graduate from high school. And then when the experiment ended, it went right back to where it was-

Dr. McGavock: Right

Dr. Forget: at the outset.

Dr. McGavock: Which is nice.

Dr. Forget: Well, it's certainly sad- So, so socially ... for people's lives, but you got- Yeah ... this nice little opportunity for a very lucky cohort of kids who came through. Mm-hmm. I c- I can't be absolutely certain of this because I, I didn't interview enough people, but just from the anecdotes that people were telling me [00:38:00] during the period, I think these were mostly boys, and it makes sense.

Dr. Forget: And the reason it makes sense is because a lot of boys told me that, or a lot of men now told me that when they were boys, these were big families, right?

Jared McKetiak: Yeah.

Dr. Forget: So if I'm talking about teenagers during the 1970s, they were all born before the birth control pill became- Yeah ... readily available. So the families were big, and if you've got a low income family with a lot of little brothers and sisters, by the time you're getting to be 15, 16 years old, there's a fair amount of family pressure to- Yeah

Dr. Forget: become self-supporting.

Dr. McGavock: Yeah. So the young boys, I would say like in 14, 15, 16 years old, you might be the second head of the household.

Dr. Forget: Oh, easily.

Dr. McGavock: Right?

Dr. Forget: Easily.

Dr. McGavock: So you're not gonna go to grade 11, 12. You're not thinking about going to university. You gotta start bringing in cash.

Dr. Forget: Well, and in fact, that's one of the things I was going to say is that there are opportunities for these boys.

Dr. Forget: Right, right. They've grown up in farms. They're strong young men.

Dr. McGavock: Yep.

Dr. Forget: And people are prepared to pay them halfway decent money Salaries in order to unload trucks and do hard [00:39:00] physical labor.

Dr. McGavock: Mm-hmm.

Dr. Forget: Um, and so these kids were leaving school before Mincome came along. Mm-hmm. They left without a complete high school.

Dr. McGavock: And I think the data there tell me that the families wanted the boys to graduate, right? And they're like, "You know what? I don't want you to go work on a farm." Yeah. "I want you to finish your grade 12," because the second biggest lever for health after income is education.

Dr. Forget: Absolutely.

Dr. McGavock: Which I can't believe that was not one of the outcomes in the majority of those other studies.

Dr. Forget: Yeah. I don't think it was something that economists were thinking about in the 1970s. Okay. Um, but there were sociologists on the experiment, but there just weren't those kinds of questions being asked. One of the interesting things I found when I went back through it was the preoccupations of social scientists in the 1970s- Okay

Dr. Forget: and the kinds of questions they asked. So things do change.

Dr. McGavock: I do wanna touch on that before we go- Oh, w- well- ... 'cause I know you're a history buff, but I was pulling up some more recent data. So we have done some systematic reviews. One was published in Social [00:40:00] Science & Medicine in 2024. You were part of it as a group- Yeah

Dr. McGavock: led out of McMaster, Department of Sociology. I think 30 natural experiments to date now, for example, the Cherokee study or others, looking at health outcomes. Yeah. No meta-analysis, but it looks like the majority of these studies are all showing positive effects.

Dr. Forget: For the most part. You've got to be a little bit careful.

Dr. Forget: I- I'm gonna go back to your question you asked a minute ago. Oh, sure. How does link basic income to health outcomes? I think, you know, the idea of basic income or guaranteed annual income is to, to really tackle some of the high level determinants of health, so things like economic inequality, poverty, income security.

Jared McKetiak: Mm-hmm.

Dr. Forget: And what that does is it does affect individual opportunities and individual capabilities. So individuals have access to better food, access to better housing. They've got a little bit of money to see a practitioner or to fill prescriptions if there's no pharmacare program.

Jared McKetiak: Mm-hmm.

Dr. Forget: Another thing that we find is that people report a lot less stress, so stress-related- Yes

Dr. Forget: conditions don't show up quite [00:41:00] so highly, so they report better mental health, for example. Behaviors change. A lot of behaviors change. People aren't quite so ready to work 80 or 90 hours a week. Maybe they work a little bit less, which is probably healthier.

Dr. McGavock: Yep.

Dr. Forget: They can afford to make decisions about their lives, and because they're not under stress, some of those actually carry through.

Dr. Forget: So those kinds of things change, and we see it in terms of better reported physical and mental health. One of the other things that happens, and it, this I think showed up in the Dauphin experiment, was people report more engagement in the community. I'll call it pro-social activities Yeah So there's more- Yeah

Dr. Forget: opportunity to volunteer, more opportunity just to participate with one another. So you've got a little bit of extra money. You can go-

Dr. McGavock: Yep ...

Dr. Forget: you know, you can go to the restaurant with your-

Dr. McGavock: Yep ...

Dr. Forget: with your friends after work, or you can- Yep ... just go out for a beer after work. You can- Yep ... you're just part of the community in a way you aren't if, you know, every penny counts and you're just- Go to the farmer's market

Dr. Forget: struggling.

Dr. McGavock: Yep.

Dr. Forget: Exactly. So I think that's how it's [00:42:00] affecting health outcomes, which should get you to the harder question and the question I ask sometimes, and that's the return on investment. Is there an economic return on investment? So I mean, if you can affect hospitalization by eight and a half percent, you know, that's a lot of money.

Dr. Forget: Mm. It turns out, I mean, in Canada, I think we're paying, what, $72, $75 billion a year on hospitals, hospital stays.

Dr. McGavock: Right.

Dr. Forget: Eight and a half percent is potentially a lot of money.

Dr. McGavock: Mm-hmm.

Dr. Forget: But you've got to be careful about it, and you've got to be careful because some of the studies report that people actually use more healthcare when they get a basic income.

Dr. McGavock: Right.

Dr. Forget: And I was using a, a reduction in hospitalizations as a proxy for better health.

Dr. McGavock: Yeah.

Dr. Forget: And they were reporting more healthcare use, so therefore it didn't have an impact on health. It really depends what you measure.

Dr. McGavock: Mm-hmm.

Dr. Forget: Because what people are doing instead of being hospitalized is actually going to their doctor and filling their prescriptions and doing all the kinds of things that keep you out of hospitals-

Dr. McGavock: Right

Dr. Forget: which is [00:43:00] not a bad outcome. Exactly. It's a pretty good return.

Dr. McGavock: Yeah.

Dr. Forget: So you've got a return both in terms of the fact that virtually every social program or social policy you have is made worse by poverty. If you can address the poverty, you're reducing the need for expenditure in some of these programs.

Dr. Forget: So the demand on these programs is declining. And on the other end of the scale, if people are going back to school and they're getting more education, getting more job training, they're getting higher incomes. They're paying more in taxes.

Dr. McGavock: Yeah.

Dr. Forget: They're spending a lot less time on employment insurance.

Dr. Forget: They're reducing the costs. They're contributing more.

Dr. McGavock: Yeah.

Dr. Forget: Another thing we found, even in the Dauphin experiment anecdotally, we had lots of people reporting starting little businesses. You know- Yeah. ... keeping businesses alive. Yeah. In Ontario a few years ago, we had a basic income experiment that Doug Ford killed as- Yes.

Dr. McGavock: as

Dr. Forget: soon as he came into power. We couldn't do any real analysis because they locked up the data and wouldn't give it to us after. No

Dr. McGavock: way.

Dr. Forget: Yeah. No, they took it all away and we couldn't do anything. Was

Dr. McGavock: this a [00:44:00] pre-COVID experiment, like 2017 to 2019? Yeah,

Dr. Forget: sort of in the dying days of Kathleen Wynne's premiership.

Dr. Forget: Oh, no. And Doug Ford, all of the parties promised to continue that experiment when they came into power, and Doug Ford changed his mind- Right ... and locked up the data. So all we have are anecdotal reports. But again, we had people reporting going back to school for more job training. Lots of them reported, uh, little business activities, small businesses, photographers and- Yeah

Dr. Forget: things like that.

Dr. McGavock: Well, and I feel like, too, small businesses led by women-

Dr. Forget: Very often ...

Dr. McGavock: have huge impacts on- Yeah ... family health.

Dr. Forget: Yeah, I think so.

Dr. McGavock: So-

Dr. Forget: It creates opportunities, and we see that a lot of these experiments have been conducted in low income countries, and so the amount of self-employment as a result of this increases dramatically.

Dr. McGavock: So if you're a budding epidemiologist and you wanna draw a DAG and you're looking for precise mechanism, you're gonna have to go back to what we call a socio-ecological model where- Yes. Yes ... it's gonna be education, it's gonna be-

Dr. Forget: It's all those

Dr. McGavock: things ... [00:45:00] behavior. Yep. A sense of community belonging. Yep.

Dr. McGavock: Empowerment of women, self-determination in the family, reduced stress, like-

Dr. Forget: Yep. Yep ...

Dr. McGavock: those are the wins.

Dr. Forget: They are. Like- You ask those questions and you get the answers back. If you ask the right questions, you get the right answers.

Dr. McGavock: How many times do you get an intervention that levers all 10 of those things at the same time?

Dr. McGavock: Well- It's like a no-brainer. Yeah.

Dr. Forget: It is, because poverty, I think, is so central.

Dr. McGavock: Mm-hmm.

Dr. Forget: It's so central to so much of what we do.

Dr. McGavock: The data suggest almost all these experiments are pointing in the right direction. We do see some increase in preventive care- Yeah ... but not, like, acute care- No ... ambulatory care.

Dr. McGavock: Yeah. Now, before we turn into your fascination with history- ... we ran into a quasi experiment with the CERB during COVID. Oh,

Jared McKetiak: yeah.

Dr. McGavock: What were your thoughts on that? So that was $2,000 a month, 500 a week- Yeah ... for 24 weeks, extended out a bit. $100 billion.

Dr. Forget: Yeah.

Dr. McGavock: Right?

Dr. Forget: Let me say, first of all, that a lot of families were a whole lot better off when that came along.

Dr. McGavock: Yeah.

Dr. Forget: A lot of families were a whole lot worse off.

Dr. McGavock: Really?

Dr. Forget: So it [00:46:00] worked.

Dr. McGavock: Yeah.

Dr. Forget: It worked. It had an impact. It certainly had an impact on wellbeing.

Dr. McGavock: I think it saved us from the chaos of COVID.

Dr. Forget: I think it did.

Dr. McGavock: Totally.

Dr. Forget: When I first saw that ex- that program coming out, I thought, "This is wonderful." A whole lot of people like me, a whole lot of middle income and upper income people who are never gonna be struggling to put food on the table-

Dr. McGavock: Mm-hmm

Dr. Forget: are now in a position where they recognize that this is necessary, and they can see how important it is.

Dr. McGavock: Yeah.

Dr. Forget: And look at how empathy will grow in society. Well, look how wrong I was. It certainly didn't happen that way. It did- There's this huge pushback against it, and this anecdotal evidence of the kid in the basement who won't go and get a job.

Dr. McGavock: Right.

Dr. Forget: And I don't know how you even say these things or how you can get people to understand, but the whole purpose of the CERB was to keep people home.

Dr. McGavock: Right.

Dr. Forget: You didn't want them to work. That's- And so you set up a program that was- Yeah ... designed to keep people home.

Dr. McGavock: Mm-hmm.

Dr. Forget: And that was exactly it. It, it reproduced all the worst, worst effects of- Stereotypes

Dr. Forget: of welfare.

Dr. McGavock: Exactly.

Dr. Forget: They did it [00:47:00] quite intentionally to keep people home, and somehow in people's minds, that got conflated with, "Oh, yeah, you see, this basic income stuff doesn't work." Mm-hmm. And I don't think it showed that at all.

Dr. McGavock: I think we ne- we need some kind of analysis of the families that were lifted out.

Dr. McGavock: Oh, yeah. Right? Where 2,000 a month- Yeah ... was, like, unheard of. You know?

Dr. Forget: It's amazing.

Dr. McGavock: Like, we're talking about, whatever, the 20-year-old kid that had a job that was staying at home. Like, that's not the reality.

Dr. Forget: No.

Dr. McGavock: For some reason, when that- No ... catches the media, it just takes off.

Dr. Forget: It does, and, uh, you know, it... The, these prejudices are very, very old.

Dr. Forget: Let me go back to my fascination with history. Yeah. I can trace that right back to the 13th century. Wow. I'm not kidding.

Dr. McGavock: Wow.

Dr. Forget: It's the end of the Bubonic plague, 1380. It really is. Okay. You know, you've got all of this upheaval in society. Before that, you had a relatively stable society, and everybody was poor.

Dr. Forget: And, you know, the beggars in your midst are, there are beggars, and it's up to us to keep them alive, and it's part of my being a good Christian to ensure that these people stay alive and can... They're part of the community.

Dr. McGavock: Right. [00:48:00]

Dr. Forget: But what happened at that period was just a whole lot of economic disruption that displaced people from the land, displaced people from their villages.

Dr. McGavock: Mm-hmm.

Dr. Forget: And so what you had were a lot of people going from village to village, and these were outsiders.

Dr. McGavock: Right.

Dr. Forget: Right? And once you start talking about outsiders, then all kinds of stereotypes start to emerge. Mm-hmm. And so you've got the men, well, the men are fl- thugs. I mean- Right ... these men are dangerous.

Dr. Forget: And so you get criminality and poverty being enjoined in people's minds. And the women, well, you know, the women are, the women are not virtuous.

Dr. McGavock: Right.

Dr. Forget: And you've- Right ... so you've got sexuality and all of that combined in people's minds. So these prejudices are very, very ancient, and I think, you know, we can see that, and we can see it happening right up to the 20th century.

Dr. Forget: And what's happened very recently is that we've somehow convinced ourselves we're beyond that. When we develop income assistance programs, we don't, we don't talk about the deserving and the undeserving anymore, but we do. I mean, it's baked into the programs. Yes. It's baked into [00:49:00] so many of the programs that we introduce.

Dr. McGavock: You have to prove X. You have to prove- All the time ... Y. You have to prove your racial identity if you wanna- It's all of it ... qualify for this.

Dr. Forget: All of it.

Dr. McGavock: Well, this distrust Of who we think is not in our community.

Dr. Forget: Yeah, that's right.

Dr. McGavock: And if it's- They're not us ... their income, they're not us They're

Dr. Forget: not us.

Dr. Forget: Exactly. They're not like us. Yeah. And I think that what COVID did was to touch on that very clearly. Mm. I think it frightened a whole lot of people- ... who are very, very keen to say, "I'm not one of them, and because I'm not one of them, I guess I'm safe." Yeah. And I will just whistle past the graveyard and-

Dr. McGavock: Yeah,

Dr. Forget: yeah

Dr. Forget: hope it doesn't happen again.

Dr. McGavock: And it's the individualization, right? Yeah. Of health-

Dr. Forget: Yeah ...

Dr. McGavock: of income, of- Yeah ... whatever. Yeah. Right? That it's all you, pull yourself up by your bootstraps. That's right. If you didn't make it, it's your fault. You didn't get there.

Dr. Forget: That's right. And you see that all the time. Well- I mean, even if I talk to, if I talk to people from Dauphin, I'll talk to people of exactly that cohort.

Dr. Forget: You know, they were part of that experiment, and I'll meet, I meet them right across the country.

Dr. McGavock: Oh, okay.

Dr. Forget: So I go to Ottawa and I'm giving a little talk, and somebody will come up, "I was part of the Dauphin experiment." "

Dr. McGavock: I was in the experiment." Oh, that must be amazing.

Dr. Forget: And then you just have a [00:50:00] little chat with them about where, you know, where'd you go to school, and what are you doing?

Dr. Forget: And it somehow just never oc- occurs to people that they were just part of a very lucky cohort that got them to university in the first place. Yes. Yeah. I'm the first person in my family who ever went to university. Well, guess what? It's the first time your family had the money- Yeah ... to support you.

Dr. McGavock: In the economics world, they call that the invisible hand.

Dr. McGavock: I, I don't think you do, but that is that. And you don't see it though, right?

Dr. Forget: No.

Dr. McGavock: Like, on both sides, you don't see it when it benefits you.

Dr. Forget: No.

Dr. McGavock: And you sure as heck don't see it when it's disincentivizing or-

Dr. Forget: No ... or di- I mean, I think we believe we have a lot more control of our- Yeah. And I mean, we do. Of course we do.

Dr. Forget: Right. But I mean, it's, you know, you make decisions within the context you are.

Dr. McGavock: Yeah. You

Dr. Forget: do the best you can given what you have.

Dr. McGavock: Absolutely. And if society is there... We were in Scandinavia a couple years ago. We were in Norway.

Dr. Forget: Mm-hmm.

Dr. McGavock: And the culture of responsibility for each other- Yeah ... your responsibility as a citizen, your responsibility to the nation, the community, the village, whatever, is much higher [00:51:00] than here, where it's like, what is my right?

Dr. Forget: Yeah, exactly.

Dr. McGavock: You don't have a right to that, but I have a right to this.

Dr. Forget: Rights and responsibilities, I think we do.

Dr. McGavock: And I think that way is to have more women in leadership.

Dr. Forget: Mm-hmm.

Dr. McGavock: Which is one of your other passions. And just thinking about this, like, how are we moving? What I see in a lot of your papers that you're writing is about the inequities, gender inequities in the economics departments.

Dr. McGavock: Are we making inroads there? And then I guess, also, your fascination with the history of these things, and then how you go about studying that. Can you tell us a little more about where are you going in these areas, and what is driving that passion?

Dr. Forget: Oh, these are hard questions. Uh, first of all, are we making progress?

Dr. Forget: Are we making progress? I think we are. Yeah. I think we are. Okay. Very, very slowly. Economics is, of all the social scientists, it's still the most male-dominated profession.

Dr. McGavock: Mm-hmm.

Dr. Forget: But it's changing very, very slowly with a lot of work. Yeah. Things will get better.

Dr. McGavock: What I have seen a lot of though, and I'm sure it's the same in your field, women don't get published as much.

Dr. Forget: Nope, they don't.

Dr. McGavock: Women don't get [00:52:00] interviewed as much. No, they don't. They're not- They don't. It's still unbelievable.

Dr. Forget: It is very, very hard. Traditional mindset. It's a very hierarchical field of study.

Dr. McGavock: But I think with women- So

Dr. Forget: it's hard to change that.

Dr. McGavock: Yes. But women in power- I think that- ... I think

Dr. Forget: it makes a

Dr. McGavock: difference

Dr. McGavock: though,

Dr. Forget: I think my career is though an exemplar of what we see. I have a PhD in economics. I'm not in an economics department. Right. I'm in community health sciences- Right ... which is a female-dominated department.

Dr. McGavock: Yeah.

Dr. Forget: And I'm there partly because it gives me the freedom to do the kind of work that interests me.

Dr. Forget: This work is interesting to people in health sciences.

Dr. McGavock: Yeah, that's true.

Dr. Forget: And so you'll see female economists in education departments, and in medical schools, and in social work departments, and in sociology. You're

Dr. McGavock: right.

Dr. Forget: The men are doing finance.

Dr. McGavock: Right. So a plug out for all- Yeah ... future trainees-

Dr. Forget: Absolutely

Dr. McGavock: is a path for you- There's lots ... in economics.

Dr. Forget: There is.

Dr. McGavock: And maybe they could reach out to you for some advice. Yeah. A-

Dr. Forget: absolutely.

Dr. McGavock: Anything on the history of science or the history of poverty that we haven't touched on that you think is important for this discussion?

Dr. Forget: As I get older, it [00:53:00] becomes more and more interesting to me to see the roots of some of these preoccupations.

Dr. McGavock: How about this one? If you had a PhD student right now that was looking at a career in this space, where would you suggest that they direct their questions? What are some of the emerging and interesting things that are happening right now?

Dr. Forget: Oh, I think social policy is a sort of a perennial issue, and I think anti-poverty policy is something we need to think about.

Dr. McGavock: Mm.

Dr. Forget: We haven't talked about the obvious elephant in the room right here, and that is AI and technological change- Yes ... and the things that are happening. Every time there's been massive technological change historically, it's created more jobs than it's destroyed.

Dr. McGavock: Yep.

Dr. Forget: But it's not so easy to take a 40-year-old miner and retrain him to be a personal care worker.

Dr. McGavock: Right.

Dr. Forget: And that's what we're talking about. Mm. So I think what we're gonna be seeing in, in the near future is gonna be a whole lot of unemployment alongside a whole lot of labor shortages. Mm. So the kinds of inequality or the kinds of income disparities we're seeing are gonna get worse and worse. And so I think one of the things we have to be asking ourselves is how do we [00:54:00] address it?

Dr. Forget: How do we address poverty? How do we address some of the inequities that exist in society and create opportunities for people? And I think basic income is one of the ways to do that, but it's only one of the ways to do that.

Dr. McGavock: The AI and basic income are now going hand in hand. Your interview in 2015 with Freakonomics-

Dr. McGavock: Podcast, the other person interviewed was Sam Altman from OpenAI, who was saying we need basic income as a response to AI. These need to go hand in hand.

Dr. Forget: Well, he saw it ahead of time.

Dr. McGavock: Yeah, exactly. And also ripe. Like, anyone who's doing any kind of social policy, anti-poverty work right now, the ca- capacity to do natural experiments- Oh,

Dr. Forget: yeah

Dr. McGavock: and to create, like, the highest level of empirical evidence around that is- Yeah ... amazing right now.

Dr. Forget: It's getting better and better. And, you know, the opportunities with the kind of data that exists, and that we have to protect.

Dr. McGavock: Mm-hmm.

Dr. Forget: We always have to protect from the kind of political backlash that can come after data.

Dr. McGavock: Right now.

Dr. Forget: It is.

Dr. McGavock: Yeah. I can't thank you enough. This was a fascinating discussion. I'm really [00:55:00] grateful that you took the time to come down here to do this in person. I'm always so proud when a Manitoban is just, like, out there and making a difference in the world and, like, showcasing how great it is to be here.

Dr. McGavock: As a Manitoban, I really wanna thank you for all the amazing work that you're doing. And for trainees, please reach out. We're gonna put all of the papers, anything we discussed today, we're gonna put in the show notes. If there's anything you think other trainees should look at, let us know. We'll put links to other interviews or videos that are out there for the work that you've done.

Dr. McGavock: And I look forward to seeing what's coming out of your work next, so.

Dr. Forget: Well, thank you very much. This has been great fun. Thank you.

Dr. McGavock: That was outstanding I have to be honest, I'm a consumer of science. I'm a consumer of the literature. When I had to pull this paper to read it again, there were so many things that I didn't know.

Dr. McGavock: This is probably one of the most cited studies in health and social science, as well as pop media and culture. [00:56:00] The backstory was fascinating. The scientific methods were things that I wasn't aware of. Jared, what were some of the things that you took away from this interview?

Jared McKetiak: Well, you know, like I said in the introduction, I grew up in a small town, and I totally understand the vibe.

Jared McKetiak: Everybody knows everybody. Everybody understands where folks are at in terms of financial status or social status. And I think that in small towns, a lot of that sort of stuff gets overlooked because the community is only as strong as its weakest member, and that's a cliche for sure. But the idea that we are going to uplift this community by making everybody equal, right?

Jared McKetiak: I think there are so many different things that you can think about and how that relates to the world that we live in now, how many years later, that we are still dealing with some of [00:57:00] the same issues that they were trying to combat by implementing the idea of a minimum income project. And it's very prescient to think that, what, 50-plus years ago- Yeah

Jared McKetiak: they're talking about the need to balance, to make sure that everybody has the same access. One of the things that really blew me away, and I didn't really think about it, I was born 1976, is how impossible it would have been for a new mother to jump right back into doing whatever. And I mean, we were talking about a time where the idea that a mother's place or a woman's place was being a homemaker and is a very antiquated view, but then you're also raising a new child, and you get, what, three weeks- Yeah

Jared McKetiak: of maternity leave? Yeah. And it's just like- Two or three weeks ... [00:58:00] bam, right? Get back into it. And now we live in this day and age where there's parental leave, there's shared leave, and in some cases, if you're lucky, you can get up to 18 months, which I think is an amazing thing that we are able to provide that to new parents because those first 18 months are so important in terms of development and in terms of forging that connection with your child.

Dr. McGavock: I had never really thought about, until I interviewed Evelyn, which is when we have programs like this, we often have to ask people to prove their poverty. Yeah. Mincome- And parental leave and extension of parental leave, you don't have to prove things

Jared McKetiak: Right You know, one of the things that I mentioned is it has shown that it is so important for everybody to have access to mental health supports, right?

Jared McKetiak: We live in this day and age where we are bombarded with [00:59:00] news, and a lot of it isn't good. I have teenagers. They come home, and they are being affected by things that I never would've even dreamt of being affected by when I was in high school. The ability for everybody to have a counselor to talk to or some sort of mental health supports access, and it's not based on where you work, if you have money, and you don't have to prove it.

Jared McKetiak: And that's one of the things, like, when people hold up the idea that Canada is a great place to live, one of the things that's always cited is universal healthcare. And I think that going above and beyond. Now, of course, detractors will say, "Well, are you gonna pay for this? How are you gonna do this?" At the end of the day, there are some areas where I think that money shouldn't matter, that the bottom line, and they talked about this, is that people who were receiving the Mincome were [01:00:00] healthier.

Jared McKetiak: They were happier. They were doing things like creating side businesses, small, little offshoot hustles, right? And it's like-

Dr. McGavock: Going for coffee in the community, being part of your community, going to the hockey arena.

Jared McKetiak: Right, and-

Dr. McGavock: Engaging in social activities.

Jared McKetiak: And there is intrinsic value to things like that everybody should be able to participate in.

Jared McKetiak: And I think that at the end of the day, we wanna build a better society where people are happier and healthier and get along. Then we need to look at universal supports, whether it's Mincome, whether it's healthcare, whatever. Those things are indicative of a truly informed community and an informed society.

Dr. McGavock: Yeah, and we're in a time now where we haven't had inequities this vast since the Great Depression. With AI coming in and maybe moving people out, I think Evelyn touched on some super important [01:01:00] concepts that the way that the Mincome is delivered, and thinking about mental health actually, if we can rise people out of poverty, we can actually maybe prevent a lot of these mental health conditions.

Dr. McGavock: Of course. And I guess my final takeaway from this-

Jared McKetiak: Mm-hmm ...

Dr. McGavock: and would love to hear your thoughts as a small town guy, Evelyn is such a great researcher, but she's also a phenomenal teacher and historian. And the fact that this mistrust of the poor had its origins back in the day of travelers, people leaving their community and entering another community, and the, the poverty and the othering of people has been with us for centuries.

Jared McKetiak: Well, and I think that, you know, we here in, in Winnipeg and on Treaty 1- There is a lot of that that goes on, and you know, you read about unfortunate situations where people are left waiting or are denied entrance or are sort of pushed to the side because they don't fit in one way, shape, or [01:02:00] form. And I think that as I get older and I am raising children and I'm trying to make them informed global citizens, it's just this i- basic idea that just be a good human and treat everybody in the way that you would wanna be treated.

Jared McKetiak: I think the one thing that I really like, too, that you touched on is it's always really cool to see Manitobans who have done really great things, like universal things. People around the world know about this project because people like Evelyn Forget made it happen, right?

Dr. McGavock: That's right. The last point I think I'd like to make to our listeners who are budding emerging scholars is that you can do social justice with research.

Dr. McGavock: We're gonna touch on that in season two. You're gonna hear about it, but Evelyn is committed to making a difference just like Jared is, just like we are, and she's doing that through her job. If you're passionate about justice and health, [01:03:00] research is a place for you to do that The Emerging Scholar podcast was recorded in the UMFM studios located at the University of Manitoba in Winnipeg, Manitoba, Canada.

Dr. McGavock: This is Treaty One territory, the original homeland of the Anishinaabe, the Ininew, and on the national homeland of the Red River Métis. Manitoba is also homeland to the Anishininew, the Dakota Oyate, and the Dene peoples. We acknowledge that our water is sourced from Shoal Lake 40 First Nation. As a settler scientist working in health research, I acknowledge TRC Call to Action Number Eighteen that health inequities between Indigenous and non-Indigenous people are the direct result of colonization.

Dr. McGavock: Winnipeg is the center for reconciliation in Canada, and where we are speaking from today is at the crossroads of Canada's history and Canada's future. We are three kilometers away from one of the most sacred meeting grounds for Indigenous people on the plains and within Turtle Island. We are also several kilometers away from one of the [01:04:00] last residential schools in the province.

Dr. McGavock: We are working collectively on reconcili-action with youth, elders, and community leaders to heal from the trauma of colonization, past and present, honor the original treaties, and create a Canada that addresses and eliminates the inequities and injustices of the past and present to create a future for Indigenous children to live and thrive.

Dr. McGavock: On behalf of the team at the Emerging Scholar Podcast, we want to thank Osani Balkaran for the great production for our opening and closing themes. We also want to thank UMFM 101.5, especially our executive producer, Jared McKetiak, for technical assistance and production on this project. We also want to thank all of our guests for the discussion and the insight that they've provided.

Dr. McGavock: Once again, thank you for listening. Be sure to subscribe to the Emerging Scholar Podcast on Apple Podcasts, Spotify, and umfm.com.