Intended for healthcare professionals

Rapid response to:

Editorials Christmas 2016

A universal basic income: the answer to poverty, insecurity, and health inequality?

BMJ 2016; 355 doi: (Published 12 December 2016) Cite this as: BMJ 2016;355:i6473

Rapid Response:

Re: A universal basic income: the answer to poverty, insecurity, and health inequality?

Dear Sirs,

I have read with great interest your Editorial "A universal basic income: the answer to poverty, insecurity, and health inequality?".

While the first results of Universal Basic Income (UBI) studies are encouraging, the introduction of a UBI should not be regarded uncritically. In fact, it is possible that the introduction of a UBI at a nation- or state-level might act as a "Trojan horse", allowing for scraping off welfare programmes, public health and public education. In fact, several Canadian economists have argued that the possible introduction of a UBI would require raising large amounts of revenues (Kesselman JR, 2013; Rozworski M, 2016). While raising taxes to obtain these revenues is a possible solution, these authors have argued that it might be unpopular with the general population (Kesselman JR, 2013) and, therefore, politicians would opt instead for cuts in social welfare (Rozworski M, 2016). On the other hand, a recent study by Richard Pereira (Pereira R, 2015) has argued that it is possible to introduce a UBI without raising taxes or cutting public universal healthcare, particularly by saving on programmes that would be rendered ineffective/redundant, and by fighting tax evasion. Unfortunately, and taking into account recent history (e.g.: The Panama Papers case), it is doubtful whether politicians would engage in a real effort to tackle tax evasion/fraud.

Therefore, I believe that the most important message of this Editorial concerns the enormous advantages of greater equality. On the other hand, in regards to the UBI, while further studies are welcomed, we should take into account all the possible practical consequences of its introduction.

Kesselman JR, 2013. A dubious antipoverty strategy. Accessed at
Rozworski M, 2016. Beware of Basic Income. Accessed at
Pereira R, 2015. Universal Basic Income and the Cost Objection: What are we Waiting For?. World Economic Review. Accessed at

Competing interests: No competing interests

30 December 2016
Sousa-Pinto Bernardo
PhD student and Researcher
CINTESIS - Center for Health Technology and Services Research
Rua Dr. Plácido Costa, Porto, Portugal