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Rethinking how we support people with disabilities—Brian Dijkema on the importance of work and reforming Canada’s system of disability benefits

Podcast & Video

In today’s episode of Hub Dialogues, Sean Speer sits down with the Cardus Institute’s Brian Dijkema to discuss his policy paper, “Breaking Down Work Barriers for People with Disabilities”, co-authored with Joanna Lewis.

The conversation touches on the difference between impairment and disability, the importance of work for people with disabilities, and how we can better allocate our scarce resources in a more just manner.

You can listen to this episode of Hub Dialogues on AcastAmazonAppleGoogleSpotify, or YouTube. A transcript of the episode is available below.

Transcripts of our podcast episodes are not fully edited for grammar or spelling.

SEAN SPEER: Welcome to Hub Dialogues. I’m your host, Sean Speer, editor-at-large at The Hub. I’m honoured to be joined today by Brian Dijkema, Vice President of External Affairs at the Cardus Institute, and co-author, along with Joanna Lewis, of an interesting new policy paper, “Breaking Down Work Barriers for People with Disabilities”. I’m grateful for the chance to speak to Brian about the paper’s key insights and analysis. Thanks for joining me, Brian, and congratulations on the paper.

BRIAN DIJKEMA: Thanks, Sean, very kind and glad to speak to you again.

SEAN SPEER: Your paper starts with an interesting distinction between disability and impairment. I thought we’d start off the conversation talking about these differences and why they matter?

BRIAN DIJKEMA: Our paper takes an understanding of disability that has emerged over time that says that disability, the fact that one is disabled, is the result not necessarily of a failure on your body or your mind, for instance, but a failure of the social setting in which you’re you’re doing your work or living. So, an easy example or an easy way to understand the difference between an impairment and a disability is that an example of an impairment is someone who, for whatever reasons, does not have the use of their legs. So, they’re incapable of moving their legs and incapable of walking, and so on. That’s something that’s an impairment. Sometimes that comes from birth, sometimes that comes as a result of an accident or a degenerative disease, or what have you. But that failure to be able to use one’s legs, that is the impairment but that does not make you disabled. 

The disability comes when there are social arrangements, material arrangements, or say like the design of a building or social arrangements, like the way in which you hire people and what have you, that prevents you from doing the things that you could otherwise do. So, an example we used in our roundtable that we did was somebody who does not have the use of their legs, who’s an accountant, trained as an accountant. An accountant to do their work does not need access to their legs. Obviously, the person would prefer to have that but does not need that. So, you can do taxes, etc., if you’re a tax accountant from a wheelchair. So, that impairment does not prevent them from doing their work. 

However, if their office has stairs, then suddenly they’re disabled because they can’t get down the stairs, they can’t get to their desk or what have you. And that’s true, that’s a sort of very clear example of the way in which our physical environment makes a disability, creates the disability. But that’s also true—as you know, Sean, we’re social creatures, and there are all kinds of things that get around, perhaps it’s work hours for somebody who has another issue where they have to be at medical issues or what have you, disability is the social context in environments that have been designed to serve the needs and capacities of people without impairment. So, clearly, a place with stairs is built for people who have legs, and if you were to put a ramp in for example for this accountant, that person would not be disabled in the sense of that particular workplace. 

So, that’s helpful, I think, because it actually helps us realize that, first of all, we’re all actually all dependent upon one another. That the the the world in which we live affects different people in different ways, and it makes us, I think, more cognizant of the fact that not all impairments need to result in disabilities. I think that actually is a hopeful thing when we’re talking about the relationship between disabilities and work. 

SEAN SPEER: We’ll come back to the distinction and how it manifests itself in public policy later in the conversation. But I want to ask about one other conceptual point that sort of frames the paper that you and Joanna produced. You do something in the paper that you don’t see very often. You basically outline some key normative principles that guide your work, and the work of Cardus more generally, on these questions. 

A two-part question for you: What are the normative ideas shaping your work? And secondly, why do you think we don’t see more of this from think tanks and policy scholars? What is the hesitancy to communicate the underlying values behind people’s work and analysis? 

BRIAN DIJKEMA: I’ll answer the first one first, because I actually do think it actually helps make sense of this paper and some of our recommendations, especially in light of the way these things are normally talked about. So, basically three principles: The first principle, and this emerges out of stuff we’ve talked about before Sean, that I know that you share is that work is a fundamental human good. That there is something related to producing—not just producing, but producing and working together, working in community—that’s a fundamental human good. It seems to be natural to human beings, and it’s something that all persons should have access to. 

So, I think there is a tendency in our society to think of work as a means to an end, and particularly that end is a financial end, that you have to work. Work is a bit of drudgery that you have to do so that you can get the cash to pay for what you really want to do, and what really makes you human being which is, you know, I don’t know, going to the club, or buying fancy first edition folios, or whatever it is. The work is really just a means to get to an end and it’s really drudgery, and it’s something we should try to avoid. If we could have all of our money without work then we’d somehow be happier. You see that all over the place, like gambling, Lotto 6/49. Just imagine, right? Like, if you just had the money, then you’d be fully free. 

And Cardus along with many others, and I think most people, are beginning to recognize this: that, yes, work can be drudgery, and work can be extremely difficult. Sometimes it can be unjust. But we are made to work, and one of the fundamental principles behind this paper is that disabled people are people. They are persons and because they’re persons, they too have that desire to work. We can talk a little bit later about how that shows up empirically, that that’s true as well, but that’s one of our basic principles that emerges. This project actually emerges out of our bigger project called Work is About More Than Money, which we’ve talked about before. So, that’s thing number one. 

So, sort of emerging out of this is that our social policy should be biased towards facilitating access to meaningful work and to its monetary and non-monetary benefits. We’re saying if there’s a social policy, we should be actually biasing that policy towards allowing people to fulfill those desires. You know, one of the empirical studies in our paper that we cite suggests that 80 percent of people who are disabled want to work. That’s actually a higher percentage of people who want—like, if you’re disabled—it’s a higher percentage of people who want to work than those who are not disabled. And so, there’s a clear desire there, and we think that our social policy should be tilted towards that. So, that’s the second principle. 

And the third one, which many think is at odds with the first one, but I don’t think it necessarily is, but the third one is, people should have a living wage. I know that that sounds like you know, you know, your listeners may be saying, “Okay, what kind of socialist are you bringing on to this show?” But again, it comes out of our tradition, that people should have enough money to live on, that nobody should be left in a situation where they don’t have enough money to provide basic clothing, food, and shelter. There are huge debates, Sean, about what a living wage is, how do you calculate it, and so on. 

But the reason why we included that principle there is because I think, this gets at your next question about why we included this overall and why others are hesitant towards it, is because I think too often in our policy debates, you actually have two poles set up that seem to be mutually exclusive. Which is, we should have people work, because if you don’t work, you don’t deserve to get paid, and if you’re not working, then you must be in such dire circumstances that you need income support from the government. What we’re saying is that what we’re after is a living wage, and our hope is that more and more of that living wage can come from employment income. 

We know that, for instance, only 34 percent of people’s income on disabilities comes from employment, as opposed to 74 percent for those who are. Even those who are poor, who are not disabled, 74 percent of their income still comes from employment. So, we’d like to see more, because as a result, just towards that bias towards work that we talked about earlier, but there are many, many cases where people with disabilities are not able to get even 75 percent or what have you of their income from employment. We do think that there’s an important role for, in this case, we would suggest there’s an important role for the state to provide income support so that people still have enough to to make a living without being destitute. I think that those things need to be held together, and I think that’s critical. When we start talking policy at the end of it, we can get into that a little bit. 

But so, then you’re asked the question, why do people hesitate? I think in general, Sean, and I’m just going to be myself here, I think in general liberalism, which is the sort of dominant ideology of our day and age, really focuses on procedure, and we like to sort of sidestep the questions about what does it mean to be a human being? Because those questions are controversial, right? People are concerned that those, because they’re so controversial, and they’re not clearly delineated by empirical research, they involve questions of judgment and involve questions of studying history and looking at human interactions over time, that sometimes it’s just easier to sidestep it or to assume it. Without implying any malevolence on anybody’s part, I think sometimes it’s just easier to just assume it and just go forward with your procedural stuff instead of just stuff. But we actually think the two of them are more interesting when they’re held in common because I think you can get creative solutions, like the ones we’re proposing here, that take some of those binaries in our culture and in our public debates around politics, and actually find new creative ways that are based on, I think, a deeper and richer view of the human being. I think that’s probably healthier for society to just own that upfront. 

And, you know, Cardus tries to do that all the time. But in this paper, we’re pretty explicit about it. What’s interesting is I think that there’s actually a high degree of consensus—there’s more consensus, I think, in our society on what it means to be human than some people would imagine. And so, we tried to start that discussion as well.

SEAN SPEER: Let me just say before we get into some of the key findings and recommendations of the paper, that as a reader, I just found it useful to have you and your co-author set out what is sometimes referred to as your priors, but basically refers to the underlying values that you’re applying to these questions. Which begs the question, it seems to me, Brian, measured against these principles, and the evidence that underpins them, how is Canada’s system of disability benefits and supports performing?

BRIAN DIJKEMA: Well, I mean, you can take the global picture and you can take the historical picture, and in that sense, we’re actually doing pretty well. It is better to be disabled in Canada in 2022 than it was to be disabled in Canada circa 1780 or 1790. Now you kind of laugh at that, I think that’s probably true for many things when it comes to income and our well-being, so okay, that’s fine. 

Globally, I think it is better to be a disabled person in Canada than it is to be a disabled person in say, the Democratic Republic of Congo, or even in places where there are wars like Ukraine right now, for instance. There’s, there’s the general sort of well-being of peace and prosperity that we’ve been blessed with here. So, that’s good. Overall, though, we’re not doing as well as we might like to think. I think sometimes that sort of global and historical perspective can cause us to rest on our laurels. But if you look at it, it’s not that great. 

I mean, as I said earlier, only about 35 percent of people’s income who have a disability comes from employment. They have a very hard time working. People who are disabled have higher levels of social isolation than people without it. They are drastically overrepresented in poverty rates, and that doesn’t even include the question of whether or not we should be measuring poverty for people with disabilities differently because of the added costs and so on that they have. And there remain, I think, significant barriers to hiring and significant barriers to people earning that living wage that we’re talking about. So, overall, okay. But I think there’s quite a bit of room to improve.

SEAN SPEER: One of those barriers is something that’s referred to as the so-called welfare wall, or what economists might call marginal effective tax rates. Depending on one’s disability benefits, taking on work may actually leave people worse off. Let me just talk a bit about that. What is the welfare wall, and how does it manifest itself in the world of disability benefits and programs?

BRIAN DIJKEMA: So, the welfare wall is, to put it sort of crassly, is the degree to which your income that you’re receiving from being on some sort of welfare payment, whether it’s a disability payment or whether it’s an unemployment support, where the costs of leaving that program that you’re enrolled in, are higher than the returns you get from leaving it to go to become employed. So, that’s, in rough, broad strokes what the welfare wall is. And it is true that despite our—I think we’ve talked about this before—despite our broad tri-partisan consensus on the good of work and an increasing bias towards work in government programs, like the Canadian workers benefit and other stuff, a subsidy, Sean, that you’ve talked about in other places, and so on, there are still in a variety of disability supports, there are still walls in which the cost of going to work are higher than the cost of staying on the program. Sometimes that’s strictly in terms of income, and that’s the easiest one to find, right? You’re going to lose. A lot of times the left they talk but it is a clawback. 

But what effectively that clawback means is you’re going to lose a percentage of your income or a dollar amount of your income for every dollar that you earned. And many cases still in Canada’s employment and disability relationship, there are still clawbacks that are not actually good. They actually function as a wall rather than the ramp, which is what they’re supposed to be. I’m surprised actually; that’s, when we talk about some of our policy recommendations, that’s the low-hanging fruit. That actually came up in our discussion from, you know, NDP supporters and conservative supporters alike, and liberals as well, who said, “Look, this is the low-hanging fruit that we should get rid of. We should be getting rid of that wall, bulldozing it and turning it into into a ramp.” So, that’s one. 

But there are other ones, Sean, that are a little bit more subtle and that involve things like the relationship of non-direct financial benefits. Like for instance, pharmaceutical benefits. So, you may have, let’s say that you have schizophrenia, which is a mental illness, and you have to take a certain amount of medications. Those drugs cost a lot of money, and to go into the workplace, you not only need to earn the income that’s going to replace the disability supports that you’re losing, but you’re also going to have to get onto a benefit plan that can cover those costs. I think that’s another area of low-hanging fruit. That we can look at how those supports can actually be put in place to allow people to work more and not less. That’s just a couple of examples where it shows up in the world of disability policy.

SEAN SPEER: In your last answer, Brian, you touched on the mix of programs, benefits, and supports available to persons with disabilities. In some cases, those are direct cash transfers, and other cases it comes in the form of services or other indirect benefits. But one thing that struck me in the paper is that the share of disability programs still tilts heavily in favour of income support programs as opposed to more active, work-related supports. 

What do you think’s behind that? Is it a philosophical issue? Or is there something else that over time has come to orient so much of the way in which we help and support persons with disabilities in the form of income support?

BRIAN DIJKEMA: That’s a good question, Seann, and it’s one that actually was unknown. And I think we actually alluded to the fact that it was unknown in our paper. So, the sort of history is, there have been a disproportionate number of people moving onto disability supports. The number of people on disability support has been growing at a rate faster than the number of people with disabilities, or that at least seems to be the case. 

There are questions, and some of these questions have been asked really well by various scholars, including people like John Stapleton who said, “What has happened actually is not that there are more disabled people, but that because other income supports have been moved or shrunk or taken away, that disability support is actually a substitution for other income supports that have been taken away.” So, that’s an open question. The open question is, have we defined disability in such broad terms that we’ve actually made it not desirable, but we’ve placed an incentive for people to get on the roles of disability? That’s an open question. I think there are debates about that, Sean, and in some cases, the answer might be yes. In other cases, it might be no. 

We do know that when you look at the ratio of money spent on income support versus employment supports—and by employment supports, I mean supports aimed at increasing people’s employment income and time spent at work—that there’s a sort of gross inequality there, and with a vast majority of that being spent on income supports. Now, there are real questions around, and our paper doesn’t take a position on whether or not that balance is imperfect, like, you know, it doesn’t try to say that really what we should be aiming for is 50/50. Because I think, as we also allude to in our paper, disability is a very…when we say disability, we were using one term but the population of people with a disability is very heterogeneous. It’s very, very complicated. Something like a muscle sprain, or a broken ankle that may heal over time is considered a disability, alongside chronic diseases like MS or what have you. And so, it’s a very diverse question and that’s the real hardship, and that’s what makes this such a difficult topic to tackle from a policy point of view.

SEAN SPEER: Well, let me take you up on that point. As you say, Brian, there is a spectrum with regards to disabilities, and that manifests itself in different labour market outcomes. There’s something like a 20-percentage point gap between the employment rate for those who are disabled and those who aren’t. But it grows to as much as a 50-percentage point gap for those who are severely disabled. So, why don’t you just talk a bit about the disability spectrum, and how public policy ought to reflect these differences?

BRIAN DIJKEMA: Right, that’s one of the questions, Sean, that we asked. To what degree is it wise for policymakers to focus on sort of a legible, simple approach to disability? There are advocates for that, and I think there’s something to that. For instance, one of our partners on the policy roundtable we did, Disability Without Poverty, is advocating for a type of, I wouldn’t say a universal benefit, but a disability benefit that would cover anybody who’s qualified as disabled and provide a certain amount of income for them to achieve that living wage issue. 

But the question is because there’s so much diversity within that—you mentioned the two categories of severe and less severe. The other bit is that our data show that people with mental illness, for instance, actually have disproportionately higher levels of unemployment as well. It’s harder for them to get access to work. So, that’s another sort of wrinkle in that discussion is what type of disability. 

And if you look at our paper, we actually produce a wheel. We looked at different provinces, and we showed these are the various programs, and I think our programs are set up to address the vast diversity of what disability actually is. There are programs run out of Veterans Affairs for soldiers who’ve been injured in war, who have PTSD. Those things may be everything from a small wound to a significant long-term, trauma dealing with that mentally. So, that’s just one. You’ve got a variety of programs for those just in the Veterans Affairs, let alone employment supports, let alone other things like assistive devices program.

So, I’ll give you an example of that. I have a colleague who has some physical challenges, and she needs braces. The coverage for those braces comes from the Ontario Assistive Devices Program. I’m a diabetic; my insulin pump comes from the same program. Two very, very different examples. So, I’m afraid I don’t have a nice, neat, and tidy answer for you, Sean, but it does show just how complicated dealing with this is. Whenever we get into complication, and whenever we get into the uniqueness of personal situations, I think it’s there that you have to start asking questions about the limits of the government’s ability to properly address these questions, or whether there should be a unique way in which a more relational context could provide better care. 

For instance, I know that in some European countries, it is trade unions, for instance, that distribute in and work out workers’ compensation benefits rather than the state itself. But I think I think there’s something to that. I think there’s something to that, that we might want to explore. It doesn’t answer the question, but at least opened the door to some new ways of thinking about policy within this regard.

SEAN SPEER: Well, the paper observes that this isn’t the final report in the series, and the project will take shape over time. I can’t help but succumb to the temptation to ask you at this stage if there are any preliminary policy directions that you think governments should be moving towards?

BRIAN DIJKEMA: Yeah, I mean I’m happy to go out and say a couple of things because I think they’re fairly low risk, and this sort of emerged in our roundtable. I alluded to this earlier, but there’s some low-hanging fruit, Sean, in terms of the welfare wall. There are some grades that are too steep, in the relationship between disability supports and employment income. I think those can be leveled quite a bit, providing greater incentive for those who want to work. And in fact, it’s probably a better incentive there. It’s just a better way to talk about removing the barriers, and that’s why we call this paper Removing Barriers. 

I think there are, surprisingly, quite a few of those still left out there, and I think those would have the broadest multiparty support. I think you could probably get those. Digging down into places like British Columbia, I know, it has some real issues there; Ontario has some as well. Looking into sort of workplace, but not always subsidies, but ways in which you can actually support people in their work rather than making it too much of a challenge. So, I think that’s the low-hanging fruit, is to start in that direction. 

The other one, Sean, and this is you know, we talked policy and people immediately think government, but I do think—and we are really grateful to have representatives from chambers of commerce and banks and so on at our event—that employers have a huge role to play in this. I mean, clearly employers are the people who employ people. I know genius, right? That’s why they pay me. That’s why I work for a think tank, Sean, I can say brilliant statements like that. But one of the things that came up in our research is that employers often think that the cost of hiring somebody with a disability is higher than it actually is. 

I think there’s this concern that you know, employers are worried about stability, they’re worried about productivity, they’re worried about, you know, lawsuits, all this other stuff. But it turns out that the costs are actually significantly lower. I think the average cost for an accommodation is less than $500. So, when we’re talking policy, I think what we’re actually talking about is actually bringing those who are deeply involved in the labour market into these discussions to show them that the returns are high, and the costs are low. And because there are actually high returns, there’s some data out there that show that: people with disabilities tend to be more reliable in terms of showing up for work and on time, the customers love people with disabilities. Like, and I’m not saying that’s particularly true—all of the things that the assumptions, and I’ll just say, stereotypes, or maybe even biases that people have, saying that there’s going to be problems, actually, the data show that the reverse is true. 

There’s lots of good work being done there, and I think that places like Chambers of Commerce, CFIB, local groups getting together to say, “Look, let’s actually make an effort to hire people with disabilities.” I think the government could be doing some work around that, too, and actually do provide a lot of work. A lot of those accommodations I mentioned, in my early sort of opening about the person, the imaginary person who doesn’t have use of their legs, that ramp could be paid for by the government. There are plenty of supports in that regard for that type of thing. And I think that’s another area to sort of build those out into luck as well.

SEAN SPEER: I’m glad you emphasize the role of business in this story. One of the proof points or data points that struck me the most in the paper was some evidence that, not only as you say disabled workers make positive contributions in their own right, but that there seems to be evidence that it affects the productivity and experience of the rest of the team. And so, especially in this era of labor scarcity, one can’t help but think that those employers that come to see persons with disabilities as potential employees will have something of an advantage. 

Brian, let me just wrap up with a kind of big picture question that is related, but somewhat separate from the conversation that we’ve been having. I’ve been struck that growing demands for redistribution in modern society have involved government programs moving up the income ladder, such that there’s a growing number of Canadians and Canadian households receiving some form of government support. 

Is there a risk, though, that this can come at the expense of marginalized groups such as persons with disabilities? In other words, isn’t one of the arguments in favour of a more limited and constrained welfare state that enables us to dedicate more scarce resources to those who really need it? And if you accept that premise, I’d be interested in your thoughts on what explains this sort of tendency away from really targeted support to those most in need to this trend of more and more public resources going to more and more people?

BRIAN DIJKEMA: That’s a great question to end, and it’s actually going to loop back, my response will loop back to that very beginning question where you asked about why we put our principles out there. I think what you’re really talking about is not necessarily a more limited welfare state, Sean. It might be that the end result is actually less spending on social welfare or what have you. I actually think you can be agnostic about that question, about the size or the more or less. And I’m not agnostic about it, but for the purpose of this discussion, I think you can be because what you’re really asking when you’re talking about people who are more or less in need, you’re asking questions about what is just and what is unjust, right? You’re talking about a just distribution of resources. And I absolutely think you’re right, that, particularly in the case of disabilities, we have spent billions of dollars giving money to those who, public money, to those who certainly can use it, but sometimes that comes at the cost of those who need it. I think in the world of disabilities, this is clearly the case. 

We have a long-standing challenge with poverty. Twenty percent of people who are disabled are in poverty. That is crazy and unacceptable. And the fact that this is happening at the same time—and I know that this is going to cause some of your listeners to roll their eyes—but that this is happening at the same time when we’re promising people who are earning hundreds of thousands of dollars $10-a-day daycare, I think is an unjust allocation of public resources. I just think that that is a totally legitimate thing to say. 

Everyone will sort of respond by saying, “You know, well, why can’t we do both?” And I’m like, well, the record has shown that we haven’t done both, and that the record has shown that we have been more prone towards expanding a list of things that provide support to those who may or may not need it. We have not had the question, we’ve not had the argument about whether or not people need that and ask real hard questions about that, and I think that’s worth it. 

Historically, in social policy, Sean, there’s the question of the deserving needy and the undeserving needy. I think too quickly, people will say, “Once you start getting into that type of question, you start getting into this sort of moralistic view of social policy and social distribution.” But I actually think those questions are unavoidable. I think there are people who have greater needs and who have lesser needs. 

I’ll just personally say, I have four children, I get significant support from the government to raise those children. That’s wonderful, I welcome that. Like I know personally, my bank account is very happy about that. But if it came down to a choice about whether or not my benefits need to be cut back 10 percent, 20 percent so that somebody who’s actually in poverty right now can do that, I think that would be a just reallocation of resources. 

We can reallocate our resources through supporting groups like Indwell, which provides affordable housing for people with disabilities, mental disabilities, in Hamilton. That’s good. I encourage people actually to give. You know, this is my routine plug to get people to continue to give more of their money away if they don’t think that allocation is just, but I do think it’s an important question, Sean, and I’m glad you asked it. I wish we would be talking about those questions of justice more often.

SEAN SPEER: Well, one way to better support persons with disabilities is to increase their ability to participate in the workforce, and to the extent that that’s a policy goal, people can read your latest paper co-authored with Joanna Lewis. It’s entitled “Breaking Down Work Barriers for People with Disabilities”, and listeners can find it on the Cardus website. Brian Dijkema, thank you for joining us for today’s Hub Dialogue.

BRIAN DIJKEMA: Always a pleasure, Sean, you ask great questions.